Prescribers' expectations and barriers to electronic prescribing of controlled substances

J Am Med Inform Assoc. May-Jun 2012;19(3):375-81. doi: 10.1136/amiajnl-2011-000209. Epub 2011 Sep 21.


Objective: To better understand barriers associated with the adoption and use of electronic prescribing of controlled substances (EPCS), a practice recently established by US Drug Enforcement Administration regulation.

Materials and methods: Prescribers of controlled substances affiliated with a regional health system were surveyed regarding current electronic prescribing (e-prescribing) activities, current prescribing of controlled substances, and expectations and barriers to the adoption of EPCS.

Results: 246 prescribers (response rate of 64%) represented a range of medical specialties, with 43.1% of these prescribers current users of e-prescribing for non-controlled substances. Reported issues with controlled substances included errors, pharmacy call-backs, and diversion; most prescribers expected EPCS to address many of these problems, specifically reduce medical errors, improve work flow and efficiency of practice, help identify prescription diversion or misuse, and improve patient treatment management. Prescribers expected, however, that it would be disruptive to practice, and over one-third of respondents reported that carrying a security authentication token at all times would be so burdensome as to discourage adoption.

Discussion: Although adoption of e-prescribing has been shown to dramatically reduce medication errors, challenges to efficient processes and errors still persist from the perspective of the prescriber, that may interfere with the adoption of EPCS. Most prescribers regarded EPCS security measures as a small or moderate inconvenience (other than carrying a security token), with advantages outweighing the burden.

Conclusion: Prescribers are optimistic about the potential for EPCS to improve practice, but view certain security measures as a burden and potential barrier.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Attitude of Health Personnel*
  • Computer Security
  • Drug and Narcotic Control*
  • Electronic Prescribing*
  • Factor Analysis, Statistical
  • Health Care Surveys
  • Humans
  • Massachusetts
  • Medication Errors / prevention & control
  • Narcotics*
  • Practice Patterns, Physicians'*


  • Narcotics