Clinical Report: Comparing User-Driven and Interruptive Real-Time Tools for Medication Adjustments in Primary Care Settings

Overview

This study evaluates the impact of modifying a real-time benefit tool (RTBT) from a user-driven to an interruptive configuration on clinician engagement and medication order changes. Results indicate that the interruptive design significantly increased RTBT display rates and the frequency of medication adjustments by clinicians.

Background

Medication affordability is a pressing issue for many US adults, particularly those with multiple chronic conditions. Real-time benefit tools (RTBTs) are designed to provide clinicians with immediate cost estimates and alternatives at the point of care, potentially improving medication adherence. However, clinician engagement with RTBTs has been limited, necessitating exploration of design modifications to enhance usability and effectiveness.

Data Highlights

No numerical data available in the source material.

Key Findings

• RTBTs are required for Medicare Part D plans since 2021 and will be mandatory in EHRs by 2028.
• Clinicians typically view RTBT cost estimates in only 1%-10% of visits.
• Changing RTBT design from user-driven to interruptive significantly increased display rates.
• Medication order changes occurred more frequently with the interruptive RTBT configuration.
• Clinician mistrust and time constraints are barriers to RTBT utilization.

Clinical Implications

Healthcare systems should consider implementing interruptive RTBT designs to enhance clinician engagement and improve medication prescribing practices. Increased visibility of cost information may lead to better patient outcomes through improved medication adherence.

Conclusion

The transition to an interruptive RTBT design appears to facilitate greater clinician interaction with cost information, potentially leading to more informed prescribing decisions. Further research is needed to assess the long-term impacts on patient outcomes.

Related Resources & Content

1. JAMA Network Open, 2026 -- Real-Time Benefit Tools in 2026—More Work Is Needed
2. American Journal of Epidemiology, 2023 -- Commentary on the Evolution, Present Landscape, and Future Directions of Interventional Pharmacoepidemiology
3. Drug Safety, 2017 -- Patient and Pharmacist Perspectives on Drug-Drug Interaction Management: Insights from a Choice-Based Conjoint Analysis
4. Medicare Program; Medicare Prescription Drug Benefit Program, 2024 -- Regulation Tracker
5. CMS Interoperability and Prior Authorization Final Rule, 2024 -- CMS
6. Drugs - Real World Outcomes — Exploring the Use of Clinical Decision Support Systems Among Hospitalized Elderly Patients: Insights from a Real-World Clinical Environment
7. Strategies to Help Patients Navigate High Prescription Drug Costs
8. Medicare Program; Medicare Prescription Drug Benefit Program; Health Information Technology Standards and Implementation Specifications, 51238-51265 [2024-12842] :: Centers For Medicare & Medicaid Services :: Department Of Health And Human Services :: Regulation Tracker :: Justia
9. CMS Interoperability and Prior Authorization Final Rule CMS-0057-F | CMS
10. ONC Decision Support Interventions Certification Criteria | The American Health Information Management Association (AHIMA)
11. Prescription Use and Spending After the Introduction of a Real-Time Prescription Benefit Tool | Clinical Decision Support | JAMA Network Open | JAMA Network
12. Effects of Real-time Prescription Benefit Recommendations on Patient Out-of-Pocket Costs: A Cluster Randomized Clinical Trial - PMC
13. Override rate of drug-drug interaction alerts in clinical decision support systems: A brief systematic review and meta-analysis - Mariano Felisberto, Geovana dos Santos Lima, Ianka Cristina Celuppi, Miliane dos Santos Fantonelli, Wagner Luiz Zanotto, Júlia Meller Dias de Oliveira, Eduarda Talita Bramorski Mohr, Ranieri Alves dos Santos, Daniel Henrique Scandolara, Célio Luiz Cunha, Jades Fernando Hammes, Júlia Salvan da Rosa, Izabel Galhardo Demarchi, Raul Sidnei Wazlawick, Eduardo Monguilhott Dalmarco, 2024
14. Clinical Decision Support (CDS) | Agency for Healthcare Research and Quality