Objectives: National surveys report the prevalence of polypharmacy in the U.S. is 15%. Inappropriate polypharmacy is preventable. Left unchecked, it increases risks for falls and fatal complications. This study explored if increased patient use of an online portal reduced unnecessary polypharmacy.
Methods: Authors conducted the study in fall 2019 in a family medicine clinic at a public medical school in the southern United States. Of the 12,000 clinic visits per year, 60% of patients use Medicaid and 70% are African American. The institutional review board declared the study exempt. During clinic visits, 65 patients not already using MyChart expressed interest in learning more about it. Of those 65, 40 randomly-chosen patients, ages 30-65, received 30 minute MyChart overviews with clinic staff, including written instructions about the sign-up process. Follow-up interviews, conducted a week later after phone and letter reminders, asked if patients had reviewed their medications in MyChart, and probed for barriers to using it. Data coding and analysis were completed by 2 physicians, one who was the patient’s provider and one who was not. Both met to resolve coding differences.
Results: All 40 patients completed the follow-up interview. 33 patients completed MyChart sign up and reviewed their medications with the physician. Of those 33, 5 had unnecessary prescriptions, and for 2 of those 5, the potential drug interactions were serious. The top three barriers to MyChart use were lack of knowledge about MyChart and its features, lack of computer or smartphone access, and lack of Internet access.
Conclusions: Although limited to one clinic, the study demonstrated a brief, in-person explanation of patient portal use could reduce polypharmacy.