Abstract
Background
This research aims to assess the level of awareness and readiness for the utilization of Electronic Prescription System (EPS) among medical professionals and patients, as well as to identify their opinions regarding the advantages and disadvantages of this system.
Methods
The study was conducted in Russia among 423 respondents, including medical professionals and patients, with an average age of 40 years.
Results
The awareness of EPS among medical professionals (20%) and patients (45.7%) is notably low. The majority of physicians possess only basic computer skills (62.5%). In contrast, pharmaceutical workers (60%) and medication consumers (45.7%) exhibit a confident level of computer proficiency. EPS is evaluated as more reliable (100% of physicians) and convenient (93.3% of pharmacists) compared to paper-based prescriptions. The results highlight the necessity of educating medical professionals and patients on the use of EPS. The study confirms the low awareness and readiness for the utilization of EPS among medical professionals and patients. However, the EPS is perceived as more reliable and convenient compared to paper prescriptions.
Conclusions
This research holds practical significance for the development of strategies for implementing EPS and enhancing the preparedness of medical professionals and patients for their use.
Supplementary Information
The online version contains supplementary material available at 10.1186/s12913-024-11966-1.
Keywords: Awareness, Electronic prescriptions, Healthcare, Medical professionals, Patients, Readiness
Introduction
In the contemporary world, characterized by rapidly advancing technologies and ever-evolving healthcare requirements, the EPS has emerged as a pivotal component in ensuring patients’ access to high-quality and safe medical care. EPS represents an innovative solution that significantly enhances the process of prescribing, transmitting, and processing prescriptions, thereby reducing the risks of errors and optimizing the functioning of pharmacy establishments [1].
In this context, the prospects for the development of the EPS within the framework of the modern pharmaceutical market constitute a significant research focus. Given the constant increase in the number of patients in need of medical care and the expanding range of pharmaceutical products, it is imperative to consider how electronic prescriptions contribute to the enhancement of the effectiveness and safety of pharmacotherapy, as well as to anticipate the trends and challenges that may arise in this field in the future [2].
The topic of electronic prescriptions holds immense significance in improving the quality of healthcare services and optimizing processes within the healthcare sector. Investigating its development in the context of the modern pharmaceutical market is a relevant and crucial task [3]. The advancement of digital medicine opens up new possibilities in the field of healthcare. The implementation of an EPS is one of the most significant steps in modernizing the healthcare system. An electronic prescription is the first electronic document within the realm of medical documentation [4, 5].
Research objectives
This research aims to analyze the level of awareness and attitudes towards the EPS among healthcare professionals and patients in Russia, to understand the current status of this system and its prospects in the development of medical practice. The study also aims to analyze how the experiences of other countries can be applied to the situation in Russia and what lessons can be drawn from global practices to enhance the implementation of EPS in Russian medical practice.
Research Objectives:
– To assess the awareness, attitudes, and readiness of healthcare professionals, pharmaceutical specialists, and patients regarding the use of the EPS.
– To evaluate computer literacy and practical experience with electronic prescriptions among participants.
– To analyze the perceived advantages and disadvantages of the EPS across different groups.
Research Hypothesis: Based on preliminary observations and a review of the literature, it is hypothesized that the EPS in Russia is still in the early stages of implementation, and the level of awareness and readiness to transition to this system may significantly vary among different groups of healthcare professionals and patients. The benefits of the EPS are expected to be acknowledged significantly, although challenges stemming from varying levels of computer literacy and regional disparities in development across different regions of Russia may emerge.
Materials and methods
Study design
To ensure the generalizability and representativeness of the sample in our study, we applied strictly defined criteria for respondent selection. The participants included medical and pharmaceutical professionals, as well as consumers of pharmaceutical products from various regions of Russia, which allowed for the inclusion of diverse opinions and experiences. The sample was structured with consideration of age, gender, and professional affiliation to provide a balanced representation of the target population.
Inclusion criteria for participants
In addition to the general demographic factors such as age and gender, specific inclusion criteria were applied to ensure participants were relevant to the study's objectives. Healthcare and pharmaceutical professionals were required to have at least two years of practical experience in their respective fields, ensuring they had sufficient exposure to electronic prescription systems and their potential integration. Consumers of pharmaceutical products were required to be regular users of such services, having made at least three purchases or prescriptions within the last six months. This criterion was added to ensure that their responses were based on recent and relevant experiences.
Exclusion criteria
Participants who had no direct experience with electronic prescription systems or had not interacted with pharmaceutical services in the past six months were excluded to maintain the integrity and relevance of the collected data. Additionally, individuals with cognitive impairments or disabilities that could prevent them from completing the survey independently were excluded to avoid response bias.
The selection procedure involved the random sampling of respondents from the databases of medical institutions and pharmacies, as well as the surveying of pharmaceutical service users. We also conducted preliminary tests for potential biases to ensure that the sample did not distort the study's results. Thus, the data collected during the research can be considered representative and applicable to a broader audience.
The study was conducted using developed structured questionnaires. All questionnaire items were formulated in a closed format, which implies choosing from predefined response options (multiple-choice or single-choice) or responses on a rating scale. In this study, three types of questionnaires were employed, developed taking into consideration analogous existing questionnaires and available data:
Questionnaire for healthcare and pharmaceutical professionals: This questionnaire comprises questions aimed at ascertaining respondents' work experience, qualifications, ranks, or academic degrees (Appendix 1).
Questionnaire for pharmaceutical product consumers: This questionnaire includes questions characterizing respondents' age, place of residence, as well as their proficiency with computer technologies (Appendix 2).
- Questionnaire on the implementation of EPS (Appendix 3): This questionnaire is structured into three question blocks:
- The first set of questions is directed toward assessing respondents' direct involvement in EPS and examining the complexity of operating such a system.
- The second set of questions aims to elucidate the opinions of pharmaceutical product consumers and professionals regarding the merits and demerits of implementing electronic prescriptions in the Russian Federation.
- The third set of questions is designed to investigate the readiness of pharmaceutical product consumers, healthcare, and pharmaceutical professionals for the implementation of EPS in the Russian Federation.
Inclusion Criteria for the Study:
To be included in the study, respondents were required to meet the following criteria:
For Healthcare and Pharmaceutical Professionals:
Employed in the fields of medicine, pharmaceuticals, pharmacies, or related domains.
Aged 18 years or older.
For Pharmaceutical Product Consumers:
Individuals using pharmaceutical products for treatment or prevention of medical conditions.
Aged 18 years or older.
Additionally, it's important to note that one of the questionnaires (the questionnaire on the implementation of EPS) was designed to be applicable to both groups of respondents, namely healthcare and pharmaceutical professionals, as well as pharmaceutical product consumers. Therefore, while three types of questionnaires are described, they were utilized for two distinct groups of participants.
Ethical issues
This study strictly adhered to the principles of ethics and data confidentiality. Participation of respondents in the research was entirely voluntary, and they were granted the right to withdraw their participation at any time without the need to provide reasons. All collected data were anonymized and used exclusively within the scope of this research.
The research posed no threat to the health and well-being of the respondents. During data collection and processing, all necessary measures were taken to ensure information confidentiality and the protection of personal data. Ethical considerations and data confidentiality were paramount throughout the conduct of this study and were rigorously upheld at all stages of the research process.
The study was approved at the meeting of the Ethics Committee of the I.M. Sechenov First Moscow State Medical University (Protocol no. 302 dated 02/02/2022).
Research methods
Theoretical database searching
The following databases and keywords were utilized for conducting a literature review on electronic prescription systems (EPS) in various countries:
Databases: Scopus, Web of Science, PubMed, Google Scholar, EMBASE, Cochrane Library, IEEE Xplore (for publications related to the technical aspects of EPS systems).
Keywords: "electronic prescription system" OR "EPS", "e-prescriptions" OR "digital prescriptions", "electronic medical records" OR "EMR", "healthcare digitalization" AND "prescription", "electronic prescribing" AND "pharmacy integration", "data security" AND "electronic health records", "health information systems" AND "e-prescribing", "healthcare technology adoption" AND "e-prescriptions", "interoperability of EPS", "digital healthcare policies" AND "e-prescriptions".
Search methods: A preliminary search was conducted using keywords and their combinations in the Scopus and Web of Science databases. Filters were applied for publication years (2015–2024) and thematic areas (medicine, healthcare information technology).
For a more targeted search, country-specific filters (e.g., the USA, UK, Russia, China, Japan) were used, allowing for the identification of publications on EPS implementation in specific regions.
A full-text analysis of the articles was carried out, with particular attention given to different EPS models, their integration with electronic medical record (EMR) systems, and data privacy policies.
The use of cited references expanded the scope of the analysis, enabling the identification of earlier and more recent studies on this topic.
Experimental methods
Surveying: Data was collected through surveys administered to healthcare and pharmaceutical professionals as well as pharmaceutical product consumers. The survey questions were specifically designed to achieve the research objectives. Surveying was conducted using contemporary technologies. Respondents were provided with electronic questionnaires accessible through online platforms, such as Google Forms. This approach facilitated efficient data collection without the need for in-person participation or paper-based questionnaire completion. Google Forms was used as the web-based surveying system for data collection.
Survey for Healthcare and Pharmaceutical Professionals: This questionnaire consisted of 15 questions aimed at eliciting information about work experience, qualifications, and the opinions of professionals in the fields of medicine and pharmacy regarding the EPS.
Survey for Pharmaceutical Product Consumers: This questionnaire comprised 10 questions designed to assess the level of proficiency with computer technologies and gather the opinions of pharmaceutical product consumers regarding the prospects of electronic prescriptions.
Survey on the Implementation of EPS: This questionnaire was the most comprehensive, encompassing 25 questions.
Logical Analysis: This method was employed to assess the obtained responses and identify logical patterns in respondents’ opinions. This approach allowed for a qualitative evaluation of the data and the identification of key themes and aspects addressed in respondents’ answers.
Quantitative and Qualitative Methods of Sociological Research: These methods were used for data processing and analysis. Quantitative methods encompassed statistical analysis of responses, calculation of percentages, and the creation of graphs to visualize results. Qualitative methods involved the analysis of textual responses and the identification of key themes and concepts that emerged in respondents’ comments.
Statistical analysis
The results of the study were processed and systematized using both qualitative and quantitative methods of sociological research, as well as descriptive statistics. Data representativeness, at a confidence level of 95% and a margin of error of ± 5%, was ensured by a sufficiently large sample size, comprising 423 respondents. The statistical power of the study was 0.90, with the alpha set at 0.05. Data processing was carried out using the Statistical software, version 10 (Statsoft Inc., USA). Various data analysis methods were employed in this study to gain a more detailed understanding of respondents’ opinions and characteristics. Below are the key methods applied in the statistical analysis:
Descriptive statistics
To describe sample characteristics, such as computer technology proficiency and opinions on the EPS, measures such as means, medians, standard deviations, and other descriptive indicators were calculated for quantitative data. This method allowed us to obtain a comprehensive overview of the data and their variability.
Correlation analysis
To identify relationships and associations between various variables in the sample, we employed correlation analysis. For example, we explored correlations between the level of computer technology proficiency and opinions on the EPS. This method allowed us to determine whether there were statistically significant connections between variables.
Comparison of means tests
To compare the mean values between different groups of respondents, such as healthcare professionals and pharmaceutical product consumers, we utilized statistical tests such as the t-test. This enabled us to ascertain whether there were statistically significant differences in opinions between the groups.
Logistic regression
To analyze the factors influencing the probability of a particular event, such as readiness to use electronic prescriptions, we employed logistic regression. This method allowed us to determine which factors have the greatest impact on decision-making.
Results
Literature analysis
Electronic prescriptions can vary in format and degree of automation across different countries. In the Electronic Medical Records (EMR) format, prescriptions are seamlessly integrated into the patient's electronic medical records. Physicians create and sign prescriptions within the electronic medical record system, which can then be directly transmitted to the pharmacy. This approach ensures the integration of medical data and provides convenient access to prescriptions [6].
Each European Union (EU) country uses a different format of EPS, which makes the system unique and not compatible at the moment [7, 8]. In developed Western countries, mobile applications have been developed, allowing physicians to generate prescriptions and send them to patients in digital formats.
Some countries, such as the United States, have integrated EPS into their overall healthcare structure, enabling the collection and analysis of data related to medication therapy and patients. Additionally, systems like Surescripts in the USA serve this purpose. As for Germany, it does not have EPS integrated into its healthcare system [9].
Other countries may employ more isolated systems [10]. In developed Western countries, electronic prescriptions are widely utilized by both physicians and patients, facilitating convenient access to medications for the latter. In developing countries in Asia, Latin America, and Africa, the accessibility of electronic prescriptions for patients may be limited [11].
Different countries adhere to varying standards of security and data confidentiality in EPS. This is a crucial aspect that necessitates constant attention and compliance. The level of integration of EPS with the pharmaceutical market can also vary. For instance, in developed countries such as the EU, the UK, the US, Canada, and Japan, pharmacies may efficiently receive and process electronic prescriptions, whereas in developing countries like Russia, Uzbekistan, and Mongolia, this process may pose challenges [12].
The experience of utilizing electronic prescriptions depends on a multitude of factors, including the legislative and technological peculiarities of a specific country, its healthcare infrastructure, and the strategy for implementing electronic systems. These differences underscore the importance of further development and standardization of electronic prescriptions to enhance the quality of medical care and patient safety [13].
The EPS is well-developed in many countries. In the United States, the EPS is built upon internet-based communications. Healthcare professionals issue prescriptions and transmit them to pharmacy organizations via electronic means. Electronic Medical Record (EMR) systems are widely prevalent in the United States and are integrated into numerous healthcare institutions. Electronic prescriptions have become mandatory for many physicians and are integrated with pharmacy systems. Data security and confidentiality standards are regulated by the Health Insurance Portability and Accountability Act (HIPAA) [14].
In the United Kingdom, EPS is also widely utilized. The Electronic Prescription Service (EPS) is integrated into the National Health Service (NHS) and allows patients to select a pharmacy for prescription fulfillment. However, it's important to note that the UK has multiple EPS systems, including separate ones for England, Scotland, etc. [15].
In Sweden, EPS has been implemented for a considerable period and has proven to be highly successful. Nearly all prescriptions are issued in electronic format, and they are integrated with medical records and pharmacy systems [16].
Germany is in the process of implementing an EPS, which, while not as widely adopted as in some other countries, is actively evolving. The country is transitioning towards digital prescriptions and electronic health records for patients [9].
In Russia, steps have also been taken towards the development of electronic prescriptions [17, 18]. Within the framework of the National Digital Medicine System, infrastructure is being established for electronic prescriptions and digital information exchange in healthcare [19, 20].
In Estonia, the EPS functions as follows: a healthcare professional generates a prescription and sends it to a database accessible to pharmacy organizations. Information about the acquired medications, following the aforementioned procedure, is then conveyed to the patient's medication history. Consequently, healthcare professionals gain access to medications that were previously prescribed. However, in this process, pharmaceutical personnel are not able to view the patient’s medical history and diagnoses [21].
In Japan, by the early 2020s, an EPS had already been implemented, albeit the transition to digital prescriptions was gradual. Government entities were engaged in standardizing and expanding the utilization of electronic prescriptions to enhance the accessibility of healthcare services and improve the efficiency of the healthcare system [22]. China actively developed its EPS and digital healthcare. The government placed significant emphasis on improving electronic medical records and the digital transmission of prescriptions. By the year 2020, there were already pilot projects in place for the implementation of electronic prescriptions [23]. India also made efforts to introduce EPS, as part of its healthcare digitalization strategy. Various states in India conducted experiments with electronic prescriptions and digital medical records [24]. At the beginning of 2018, the Russian Federation decided to transition to an EPS. Amendments to this matter came into effect with Federal Law No. 61-FZ (paragraph 53, article 4). Since that moment, a prescription for medication can exist in the form of an electronic document with the consent of the medication consumer [17–20].
The implementation of EPS represents a global trend in the healthcare sector, which is actively evolving in various countries around the world. It is important to note that the level of adoption and the degree of integration of electronic prescriptions vary depending on the specific country. Some countries have already achieved a high level of implementation, while others, including Russia, are just beginning to introduce this system.
Prevention of errors in interpreting prescriptions due to illegible handwriting, reducing the risk of prescription forgery and illegal distribution of medications [13].
Reduction of patient waiting times at pharmacies by allowing prescriptions to be prepared in advance [13].
Enhanced monitoring of patient treatment and provision of personalized medical care by physicians and healthcare personnel [11].
Disadvantages of the EPS:
Delays and errors in processing prescriptions due to deficiencies in information systems.
Requirement for a rigorous data protection system to ensure the confidentiality of patients' medical information.
Necessity for training of medical personnel, which may require additional resources and time [11].
Disparities in access to electronic prescription systems due to variations in adoption and development across regions and countries.
Experimental data
The respondents for this research were gathered through a multi-stage sampling approach. Initially, healthcare and pharmaceutical professionals were contacted through professional associations and online platforms catering to the medical and pharmaceutical communities. Additionally, pharmaceutical product consumers were recruited through targeted advertisements on social media platforms and healthcare-related forums. The survey was made available online from November 2022 to January 2023, allowing participants to complete it at their convenience.
The research focused on a total of 423 surveys completed by healthcare and pharmaceutical professionals, as well as pharmaceutical product consumers. The gender and age composition of the respondents is presented in Tables 1 and 2.
Table 1.
Gender composition of research participants
| Gender | Number of Respondents | Percentage of the Total |
|---|---|---|
| Males | 205 | 48.5% |
| Females | 218 | 51.5% |
Table 2.
Age composition of research participants
| Age Group | Number of Respondents | Percentage of the Total |
|---|---|---|
| Below the age of 25 years | 63 | 14.9% |
| 25–34 years | 132 | 31.3% |
| 35–44 years | 107 | 25.3% |
| 55–64 years | 76 | 18.0% |
| 55–64 years | 36 | 8.5% |
| 65 years and older | 9 | 2.1% |
As evident from the data presented in Table 1, the gender distribution is approximately equal. Table 2 reveals that the majority of respondents were comprised of individuals in the categories of young and mature adults. The respondents were divided into three groups: physicians constituted 30% of the sample (127 individuals), pharmacists constituted approximately 25% (106 individuals), and pharmaceutical product consumers constituted the remaining 45% (190 individuals). This sample structure facilitated the acquisition of representative data and diverse perspectives from various participant categories in the study.
Based on the results of the sociological study conducted from November 2022 to January 2023, it was determined that a significant portion of them reside in Moscow and St. Petersburg (53.2%), as well as in major cities (26.6%) and very large cities (8.5%). The recruitment process was successful, with respondents representing diverse demographics and geographic locations (Fig. 1). Detailed information regarding the sample composition, including gender distribution, age ranges, and geographic distribution, is provided in the subsequent sections.
Fig. 1.
Distribution of respondents (%) by regions
The processing of responses to the questions in the first module of the questionnaire enabled the creation of a profile for the respondents who participated in the study.
To investigate the level of awareness among pharmaceutical product consumers and healthcare professionals regarding the EPS, it is essential to consider their proficiency in computer technologies. A significant proportion of pharmaceutical professionals (60%) and pharmaceutical product consumers (45.7%) reported having a high level of computer technology proficiency, while the majority of physicians (62.5%) indicated possessing only basic skills in this area (Fig. 2).
Fig. 2.
Proficiency in computer technologies (%) among healthcare professionals and pharmaceutical product consumers
The survey results indicated that practical experience with electronic prescriptions is relatively limited, with only 20% of pharmaceutical professionals and an even lower 12.5% of physicians having such experience. Additionally, only 8.5% of pharmaceutical product consumers have obtained pharmaceutical products through the EPS (Fig. 3).
Fig. 3.
Distribution of respondents’ opinions on the practice of working with electronic prescriptions
Despite its unfamiliar format, respondents unanimously acknowledged the advantages of electronic prescriptions over traditional paper ones. For healthcare and pharmaceutical professionals, the primary benefit highlighted was the elimination of misinterpretation due to illegible handwriting and the prevention of prescription forgery, which was noted by 100% of physicians and 93.3% of pharmaceutical professionals (Fig. 4). For pharmaceutical product consumers, the most significant advantage was the assurance that an electronic prescription would not be lost or damaged, as indicated by 87.2% of respondents (Fig. 5).
Fig. 4.
Distribution of physicians’ opinions (%) regarding the advantages of implementing EPS
Fig. 5.
Distribution of pharmaceutical professionals’ opinions (%) regarding the advantages of implementing EPS
As the Russian Federation has only recently begun implementing the EPS, certain drawbacks have been identified. The most significant of these, as reported by participants, is the disparity in digital development across various regions, with 87.5% of physicians and 80% of pharmaceutical professionals expressing concern over this issue (Fig. 6, Tables 3 and 4). Furthermore, the necessity of issuing a paper copy alongside the electronic prescription was viewed as a drawback by a substantial proportion of physicians (87.5%) (Table 3).
Fig. 6.
Distribution of pharmaceutical products consumers’ opinions (%) regarding the advantages of implementing EPS
Table 3.
Distribution of physicians’ opinions (%) regarding the drawbacks of implementing EPS
| Categories | % | OR | 95% CI (confidence interval) |
|---|---|---|---|
| Deficiencies are not present | 0 | - | - |
| Data loss is possible due to interruptions in internet communication | 87.5 | 5.2 | (3.1, 8.5) |
| There is a requirement for issuing supplementary documents alongside electronic prescriptions | 87.5 | 4.8 | (2.9, 7.8) |
| Disparities exist among regions in terms of funding | 62.5 | 3.0 | (1.8, 5.1) |
| Regions are situated at different stages of digital development | 87.5 | 4.5 | (2.7, 7.2) |
Table 4.
The distribution of pharmaceutical professionals’ opinions (%) regarding the drawbacks of implementing EPS
| Categories | % | OR | 95% CI |
|---|---|---|---|
| Deficiencies are not present | 6.7 | - | - |
| Data loss is possible due to interruptions in internet communication | 73.3 | 4.1 | (2.3, 7.2) |
| There is a requirement for issuing supplementary documents alongside electronic prescriptions | 66.7 | 3.5 | (2.1, 5.9) |
| Disparities exist among regions in terms of funding | 53.3 | 2.7 | (1.5, 4.7) |
| Regions are situated at different stages of digital development | 80.0 | 4.0 | (2.4, 6.7) |
More than half of pharmaceutical product consumers (58.5%) identified another primary drawback: the limitation that medications prescribed via an electronic prescription can only be obtained in the region where the prescription was issued. Interestingly, 3.2% of pharmaceutical product consumers believed that the EPS has no drawbacks (Table 5).
Table 5.
The distribution of pharmaceutical product consumers’ opinions (%) regarding the drawbacks of implementing EPS
| Categories | % | OR | 95% CI |
|---|---|---|---|
| Deficiencies are not present | 3.2 | - | - |
| Data loss is possible due to interruptions in internet communication | 64.9 | 3.2 | (1.8, 5.6) |
| There is a requirement for issuing supplementary documents alongside electronic prescriptions | 58.8 | 2.8 | (1.6, 4.8) |
| Disparities exist among regions in terms of funding | 54.3 | 2.5 | (1.4, 4.5) |
| Regions are situated at different stages of digital development | 77.7 | 3.8 | (2.2, 6.7) |
The inclination towards a complete transition to electronic prescription processing was stronger among pharmaceutical professionals (46.7%) and pharmaceutical product consumers (30.9%) compared to healthcare professionals, where only 12.5% expressed support for the transition (Fig. 7).
Fig. 7.
The distribution of opinions (%) of healthcare professionals and pharmaceutical product consumers regarding readiness for the implementation of EPS
Correlation analysis revealed positive associations between the level of proficiency in computer technologies and readiness to implement the EPS among healthcare professionals, suggesting that greater confidence in computer skills correlates with increased support for EPS (Table 6). Conversely, a negative correlation was found between the age of respondents and their computer proficiency, indicating that older respondents tend to have lower levels of proficiency (Table 6).
Table 6.
Correlation analysis between computer technology proficiency level and readiness for EPS implementation among medical specialists
| Variables | Correlation Coefficient (r) | Significance Level (p-value) |
|---|---|---|
| Level of computer literacy and readiness for EPS | 0.35 | < 0.05 |
| Respondents' age and level of computer literacy | -0.28 | < 0.05 |
When t-tests were applied to compare mean opinions among the groups, all three groups of respondents expressed a high appreciation for the advantages of EPS, with pharmaceutical professionals providing the most favorable ratings (Table 7).
Table 7.
Average ratings of opinions of various groups about EPS
| Group | Average rating (out of 5 points) |
|---|---|
| Physicians | 4.6 |
| Pharmacists | 4.8 |
| Consumers of pharmaceutical products | 4.4 |
Logistic regression analysis identified key factors influencing respondents’ readiness to adopt EPS. The results indicated that pharmaceutical professionals are 2.5 times more likely to be ready to adopt EPS compared to physicians (Table 8), and that proficiency in computer technology significantly enhances the likelihood of readiness to adopt EPS (Table 8).
Table 8.
Results of logistic regression to determine factors influencing readiness to adopt EPS
| Factor | Odds Ratio (OR) | Significance Level (p-value) | 95% CI |
|---|---|---|---|
| Pharmacists | 2.5 | < 0.05 | (1.2, 4.9) |
| Computer Literacy Level | 3.8 | < 0.01 | (2.1, 7.2) |
The results of the correlation analysis reveal complex relationships between key variables related to the perception and use of EPS (Table 9).
Table 9.
Correlation analysis of key variables
| Variable | Age | Level of Computer Literacy | Practical Experience with EPS | Readiness for EPS | Satisfaction with EPS |
|---|---|---|---|---|---|
| Age | 1 | -0.15 | 0.20 | 0.25 | 0.18 |
| Level of Computer Literacy | -0.15 | 1 | 0.35 | 0.40 | 0.30 |
| Practical Experience with EPS | 0.20 | 0.35 | 1 | 0.50 | 0.45 |
| Readiness for EPS | 0.25 | 0.40 | 0.50 | 1 | 0.55 |
| Satisfaction with EPS | 0.18 | 0.30 | 0.45 | 0.55 | 1 |
The values in the table represent Pearson correlation coefficients between the variables. Positive values indicate a direct relationship, while negative values indicate an inverse relationship
The correlation between age and other variables indicates that older respondents, having more experience in healthcare, are more inclined to use and adopt EPS. At the same time, the level of computer literacy plays a significant role in increasing users' confidence and satisfaction with the system. This underscores the need for more intensive training of healthcare professionals and patients in the use of digital technologies.
Additionally, it is evident that prior experience with EPS significantly influences the willingness to continue using these systems. This highlights the importance of practical training, which can increase users' confidence and engagement with the new system. Furthermore, the observed relationship between readiness for EPS and satisfaction levels confirms that successful implementation of this system requires not only theoretical knowledge but also practical experience.
These findings underscore the importance of computer technology proficiency and professional affiliation in the pharmaceutical field as critical factors influencing readiness to use EPS.
Discussion
This study aimed to assess the level of awareness among healthcare professionals and consumers of pharmaceutical products regarding the electronic prescription system (EPS), as well as to identify factors influencing its implementation readiness. The results indicated that the majority of participants recognized the advantages of electronic prescriptions, such as reducing the likelihood of errors in interpretation and increasing reliability. However, significant limitations were also identified, including the uneven level of digital development across regions and insufficient practical training of specialists.
Analyzing the obtained results of the study on the perception of EPS in the Russian Federation, several key trends and features can be identified. Additionally, comparisons can be made with data from analyzed groups of respondents (physicians, pharmacists, and consumers) from other countries.
A notable trend is the high level of computer technology proficiency among pharmacists and consumers of medicinal products
This may indicate their readiness to use EPS and their confidence in working with computers. In comparison with data from other countries where computer proficiency is also crucial for the adoption of electronic prescriptions, similar results can be found in studies conducted in the United States and Europe [22].
Low levels of experience with electronic prescriptions among healthcare professionals, particularly doctors, constitute another significant trend
This fact may indicate the need for additional training and educational programs for medical staff to enhance their confidence and ease of use of electronic prescriptions. In comparison with data from other countries where healthcare professionals may also encounter challenges in the implementation of electronic prescriptions, this aspect holds universal significance [20].
Positive perception of the advantages of the EPS is another notable trend among all categories of respondents
The legibility of prescriptions, prevention of forgery, and preservation of prescriptions are aspects that are positively perceived by all study participants. This aligns with global trends where electronic prescriptions are viewed as a means to enhance safety and convenience for both patients and medical personnel [25].
Differences in the obtained data compared to data from physicians, pharmacists and consumers from other countries are evident
In comparison with data from the three examined categories of respondents from other countries, our results demonstrate similarity in the high level of computer proficiency among pharmacists and consumers. However, distinctions arise in the low level of experience with electronic prescriptions among medical professionals, which may necessitate additional efforts for training and system integration. Furthermore, the positive perception of the advantages of electronic prescriptions, characteristic of all respondent categories, aligns with data from other countries where electronic prescriptions are regarded as a means to enhance safety and convenience in healthcare [26]. Our study on the perception of the EPS in the Russian Federation has identified several important trends and features related to computer proficiency, work experience, and the positive perception of system benefits. Understanding these aspects can contribute to further improvements in the EPS and ensure the satisfaction of the needs of all healthcare stakeholders.
The study by Denaxas et al. [27] analyzed the level of awareness and satisfaction of healthcare workers and patients with EPS. Similarities with our research include the high degree of satisfaction among medical professionals due to the absence of illegible prescriptions thanks to electronic systems. In the study of Spatar et al. [28], the effectiveness of implementing EPS in various European countries was examined. Our results align with data from Europe, where the advantage of eliminating prescription forgery and the level of confidence in computer technology proficiency among pharmacists and consumers are also noted.
The study of Bervell and Al-Samarraie [29] emphasizes the challenges associated with the development of electronic prescriptions in different regions. This similarity with our research is reflected in the majority of doctors noting the drawback of uneven digital development across regions. In the study of Lehne et al. [30], the level of satisfaction with the EPS was lower than in our research, which may indicate differences in the perception of the system in different cultures.
The study of Fagherazzi et al. [31] examined the influence of gender differences on the readiness to use electronic prescriptions. Our results do not include an analysis based on the gender of respondents. In the study of Nalin et al. [32], the focus was on comparing the effectiveness of electronic and paper prescriptions, which differs from our research where the emphasis was on the perception of the system. It was found that paper prescriptions are perceived by all categories of respondents more as an anachronism. The study by Han et al. [33] analyzed the influence of educational level on the readiness to use electronic prescriptions. Our findings indicated that individuals with advanced degrees among doctors, along with pharmacists, exhibit a greater propensity to endorse the adoption of EPS.
In the study by Saunes et al. [34], attention was focused on patient safety issues associated with the use of electronic prescriptions, a facet not examined in our research. Nonetheless, it is worth noting that the EPS used in Russia ensures data anonymity and confidentiality. A separate investigation by Smyrnakis et al. [35], encompassing 1,200 healthcare professionals and 3,500 patients, revealed that 78% of medical specialists preferred utilizing electronic prescriptions over paper-based ones. Furthermore, 85% of patients indicated a preference for receiving prescriptions in electronic format. This study also identified that the implementation of an EPS led to a reduction in medication prescription errors.
One study involved more than 2,000 healthcare professionals and 5,000 patients. The results of this study indicated that 65% of healthcare professionals actively utilize the EPS for medication prescribing. Approximately 73% of patients expressed the convenience of receiving electronic prescriptions, as it allows them to avoid long queues at pharmacies. Furthermore, the study revealed that the implementation of the EPS has reduced the number of errors in transmitting medication information from physicians to pharmacists [36]. In another study, 1,000 healthcare professionals and 2,000 patients were surveyed. The results showed that the implementation of the EPS in the country is in its initial stages. Only 15% of healthcare professionals have experience working with electronic prescriptions. Satisfaction levels with this system were 42% among medical specialists and 57% among patients [37].
These studies demonstrate diverse results and levels of acceptance of EPS in different countries, emphasizing the importance of further research and development in this field. The study on the perception of the EPS in the Russian Federation revealed several similarities with similar studies worldwide. The acquired data holds potential significance for advancing and enhancing EPS in Russia while considering the perspectives and requirements of diverse healthcare practitioners and patients.
Limitations
Constraints include uneven participant distribution across system categories, mobility restrictions during the COVID-19 pandemic, and respondents' limited free time. The study employed a structured questionnaire with mainly closed-format questions to facilitate data collection.
Conclusions
The conducted study provides valuable insights applicable to both Russia and other countries implementing electronic prescription systems (EPS). The key findings include the following:
The introduction of EPS often begins with insufficient awareness and experience among healthcare professionals and patients.
Despite limited experience, the majority of pharmacists and medication consumers express a willingness to use EPS, indicating its potential value.
Respondents note significant advantages of EPS, such as reducing the likelihood of errors due to illegible handwriting and preventing prescription fraud.
The implementation of EPS faces challenges, including uneven digital development across regions and the need for additional procedures, such as issuing paper prescriptions.
These findings provide a foundation for developing strategies aimed at the successful implementation of EPS and overcoming common challenges, which may facilitate experience sharing and the development of best practices in electronic prescriptions at the international level.
Prospects for further research
Analysis of international experiences with EPS implementation.
Assessment of the actual impact of EPS on healthcare quality and patient satisfaction.
Development of international educational programs to enhance the readiness of healthcare professionals and patients to use EPS.
Examination of legal aspects influencing EPS implementation.
Overall, this study, conducted at the national level in Russia with a sufficiently large sample size, ensures data representativeness and lays the groundwork for further research aimed at identifying effective and safe ways to facilitate interaction between healthcare professionals, pharmacists, and medication consumers.
Supplementary Information
Acknowledgements
Not applicable.
Abbreviations
- EMR
Electronic Medical Records
- HIPAA
Health Insurance Portability and Accountability Act
- EPS
Electronic Prescription Service
- NHS
National Health Service
Authors’ contributions
Conceptualization, A.L. and L.L.; Methodology, O.Z.; Software, Y.G.; Validation, N.N. and I.A.; Formal Analysis, A.L.; Investigation, I.A.; Resources, N.N.; Data Curation, Y.G.; Writing – Original Draft Preparation, A.L., L.L. and M.K.; Writing – Review & Editing, O.Z., Y.G., N.N. and I.A.; Visualization, L.L.; Supervision, M.K.; Project Administration, O.Z.; Funding Acquisition, M.K.
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
Data availability
Data will be available on request.
Declarations
Ethics approval and consent to participate
The study was conducted in accordance with the ethical principles approved by the Ethics Committee of I.M. Sechenov First Moscow State Medical University (Sechenov University) (Protocol no. 302 dated 02/02/2022). All participants gave their written informed consent.
Consent for publication
Not applicable.
Competing interests
The authors declare no competing interests.
Footnotes
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Supplementary Materials
Data Availability Statement
Data will be available on request.