Effect of computerised prescribing on use of antibiotics

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Abstract
Objectives: To examine whether the use of current prescribing software systems might raise rates of repeat prescribing, with a consequent increase in use of antibiotics in the community. Design and setting: A prospective audit of consecutive prescriptions for amoxycillin, cefaclor, roxithromycin and amoxycillin/clavulanate presented to community pharmacies in the Hunter region of New South Wales and a follow‐up survey of people who received a repeat prescription, October to November 2000. Main outcome measures: The frequency of repeat prescription ordering on computer‐generated and handwritten prescriptions; the proportion of people who filled their repeat prescription. Results: Data were collected for 1667 prescriptions presented to 35 pharmacies; 126 people who received repeat prescriptions completed the survey. The rate of repeat prescription ordering on computer‐generated prescriptions was 69%, compared with 40% for handwritten prescriptions (odds ratio, 3.3; 95% CI, 2.6–4.2). Computer‐generated repeat prescriptions were as likely to be filled as hand‐written prescriptions (61% and 69%, respectively). Conclusions: The default settings on computerised prescribing packages result in a significant increase in the use of antibiotics. We estimate these settings result in about 500 000 additional prescriptions being filled annually in Australia for the four antibiotics in the study.