{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T00:07:46Z","timestamp":1747872466459,"version":"3.37.3"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T00:00:00Z","timestamp":1665705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Doris Duke Early Clinician Investigator Award"},{"name":"NCPDP Foundation"},{"name":"AHRQ for research on CancelRx"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Electronic communication of prescription discontinuation, or CancelRx, has the potential to improve medication safety. We aimed to describe the proportion of discontinued outpatient medications that would result in a CancelRx message to understand its impact on medication safety. We used a data report to identify all outpatient medications discontinued in the electronic health record (EHR) of an academic health system in 1 month (October 2018). Among all 63\u200a485 medications discontinued, 23\u200a118 (36.4%) were e-prescribed, 25\u200a982 (40.9%) were patient-reported or reconciled, and the remainder prescribed nonelectronically. Discontinued high-risk medications were more likely to be e-prescribed (2768 of 5896, 47.0%). A discontinuation reason was specified in 37\u200a353 (58.9%) of all discontinued medications. Approximately one-third to one-half of discontinued medications were e-prescribed within the same EHR and would result in a CancelRx message to the pharmacy. Extension of this functionality to medications reconciled in the EHR could significantly expand the impact of CancelRx on medication safety. In addition, complete and accurate discontinuation reasons are needed to optimize CancelRx implementation.<\/jats:p>","DOI":"10.1093\/jamia\/ocac181","type":"journal-article","created":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T21:43:47Z","timestamp":1665783827000},"page":"2101-2104","source":"Crossref","is-referenced-by-count":3,"title":["Discontinuation of outpatient medications: implications for electronic messaging to pharmacies using CancelRx"],"prefix":"10.1093","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7345-7525","authenticated-orcid":false,"given":"Samantha I","family":"Pitts","sequence":"first","affiliation":[{"name":"Department of Medicine, Johns Hopkins University School of Medicine , Baltimore, Maryland, USA"}]},{"given":"Yushi","family":"Yang","sequence":"additional","affiliation":[{"name":"Armstrong Institute, Johns Hopkins Medicine , Baltimore, Maryland, USA"}]},{"given":"Bridgette","family":"Thomas","sequence":"additional","affiliation":[{"name":"Johns Hopkins Home Care Group, Johns Hopkins Medicine , Baltimore, Maryland, USA"}]},{"given":"Allen R","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Oncology, Johns Hopkins University School of Medicine , Baltimore, Maryland, USA"},{"name":"Department of Pediatrics, Johns Hopkins University School of Medicine , Baltimore, Maryland, USA"}]}],"member":"286","published-online":{"date-parts":[[2022,10,14]]},"reference":[{"issue":"10","key":"2022111608002339900_ocac181-B1","doi-asserted-by":"crossref","first-page":"700","DOI":"10.7326\/0003-4819-157-10-201211200-00006","article-title":"Pharmacy dispensing of electronically discontinued medications","volume":"157","author":"Allen","year":"2012","journal-title":"Ann Intern Med"},{"issue":"3","key":"2022111608002339900_ocac181-B2","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1331\/JAPhA.2015.14154","article-title":"Incidence and cost of medications dispensed despite electronic medical record discontinuation","volume":"55","author":"Baranowski","year":"2015","journal-title":"J Am Pharm Assoc"},{"issue":"7","key":"2022111608002339900_ocac181-B3","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1007\/s11606-016-3606-5","article-title":"Automatic errors: a case series on the errors inherent in electronic prescribing","volume":"31","author":"Lourenco","year":"2016","journal-title":"J Gen Intern Med"},{"issue":"5","key":"2022111608002339900_ocac181-B4","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1001\/jama.2016.19908","article-title":"Responsible e-prescribing needs e-discontinuation","volume":"317","author":"Fischer","year":"2017","journal-title":"JAMA"},{"issue":"11","key":"2022111608002339900_ocac181-B5","doi-asserted-by":"crossref","first-page":"1877","DOI":"10.1377\/hlthaff.2018.0725","article-title":"Prescription for enhancing electronic prescribing safety","volume":"37","author":"Schiff","year":"2018","journal-title":"Health Aff"},{"issue":"7","key":"2022111608002339900_ocac181-B6","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1093\/jamia\/ocab038","article-title":"CancelRx: a health IT tool to reduce medication discrepancies in the outpatient setting","volume":"28","author":"Watterson","year":"2021","journal-title":"J Am Med Inform Assoc"},{"issue":"2","key":"2022111608002339900_ocac181-B7","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1055\/s-0039-1688698","article-title":"Understanding CancelRx: results of end-to-end functional testing, proactive risk assessment, and pilot implementation","volume":"10","author":"Pitts","year":"2019","journal-title":"Appl Clin Inform"},{"issue":"10","key":"2022111608002339900_ocac181-B8","doi-asserted-by":"crossref","first-page":"1384","DOI":"10.1001\/jamainternmed.2021.4878","article-title":"Underuse of electronic health record features\u2014the case for CancelRx","volume":"181","author":"Nelson","year":"2021","journal-title":"JAMA Intern Med"},{"key":"2022111608002339900_ocac181-B9","first-page":"100108","article-title":"CancelRx implementation: observed changes to medication discontinuation workflows over time","volume":"5","author":"Watterson","year":"2022","journal-title":"Explor Res Clin Soc Pharm"},{"issue":"6","key":"2022111608002339900_ocac181-B10","doi-asserted-by":"crossref","first-page":"e934","DOI":"10.1097\/PTS.0000000000000998","article-title":"The impact of electronic Communication of Medication Discontinuation (CancelRx) on medication safety: a pilot study","volume":"18","author":"Pitts","year":"2022","journal-title":"J Patient Saf"},{"issue":"12","key":"2022111608002339900_ocac181-B11","doi-asserted-by":"crossref","first-page":"1658","DOI":"10.7326\/M21-1523","article-title":"Trends in outpatient care for medicare beneficiaries and implications for primary care, 2000 to 2019","volume":"174","author":"Barnett","year":"2021","journal-title":"Ann Intern Med"},{"issue":"11","key":"2022111608002339900_ocac181-B12","doi-asserted-by":"crossref","first-page":"1516","DOI":"10.1093\/jamia\/ocy100","article-title":"Analysis of medication therapy discontinuation orders in new electronic prescriptions and opportunities for implementing CancelRx","volume":"25","author":"Yang","year":"2018","journal-title":"J Am Med Inform Assoc"},{"issue":"11","key":"2022111608002339900_ocac181-B13","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.2165\/00002018-200831110-00005","article-title":"Detection of adverse drug events and other treatment outcomes using an electronic prescribing system","volume":"31","author":"Eguale","year":"2008","journal-title":"Drug Saf"},{"issue":"12","key":"2022111608002339900_ocac181-B14","first-page":"1085","article-title":"Reasons for discontinuation of medication during hospitalization and documentation thereof: a descriptive study of 400 geriatric and internal medicine patients","volume":"170","author":"van der Linden","year":"2010","journal-title":"Arch Intern Med"}],"container-title":["Journal of the American Medical Informatics Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jamia\/article-pdf\/29\/12\/2101\/47027856\/ocac181.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jamia\/article-pdf\/29\/12\/2101\/47027856\/ocac181.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T08:01:37Z","timestamp":1668585697000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jamia\/article\/29\/12\/2101\/6761308"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,14]]},"references-count":14,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,10,14]]},"published-print":{"date-parts":[[2022,11,14]]}},"URL":"https:\/\/doi.org\/10.1093\/jamia\/ocac181","relation":{},"ISSN":["1067-5027","1527-974X"],"issn-type":[{"type":"print","value":"1067-5027"},{"type":"electronic","value":"1527-974X"}],"subject":[],"published-other":{"date-parts":[[2022,12,1]]},"published":{"date-parts":[[2022,10,14]]}}}