Article Impact Level: HIGH Data Quality: STRONG Summary of JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2025.0185 Dr. Mili Mehta et al.
Points
- This study evaluated the impact of changing the default electronic health record (EHR) prescription length for statins to 90 days across 163 primary care practices at Penn Medicine in November 2022.
- The change increased the proportion of 90-day statin prescriptions from 70.7% to 91.7%, with a 20.3 percentage point increase, improving prescription duration across all demographic groups, including Hispanic and Black patients.
- The modification in the EHR system was effective in improving statin prescription consistency, requiring no additional clinician workload, and enhancing long-term adherence to statin therapy for better cardiovascular management.
- The study found that the intervention significantly reduced disparities in statin prescription durations among different racial and socioeconomic groups, promoting more equitable access to medication.
- The results highlight the effectiveness of simple EHR system changes in improving health outcomes, demonstrating the potential of behavioral science and systemic interventions to enhance patient care and promote equity.
Summary
This study evaluated the impact of a simple change in electronic health record (EHR) defaults on statin prescription durations in an extensive health system. In November 2022, the default prescription length for statins was changed to 90 days across 163 primary care practices at Penn Medicine. This shift aimed to increase the number of patients receiving 90-day statin prescriptions, which has been linked to better medication adherence and cardiovascular outcomes. The study compared prescription patterns before and after the default change, including the impact on racial and socioeconomic disparities.
The results showed a significant increase in the proportion of statin prescriptions written for a 90-day supply, rising from 70.7% before the intervention to 91.7% after the default change, a 20.3 percentage point increase (95% CI, 18.3-22.2, P<0.001). This improvement was consistent across various demographic groups, including Hispanic and Black patients, with lower baseline rates of 90-day prescriptions. By the end of the study, 90% of patients in all racial and socioeconomic groups were receiving 90-day prescriptions, closing the gap in prescription duration disparities.
The study highlights how a simple modification in the EHR system can substantially improve the consistency of long-term statin prescriptions, with no additional clinician workload required. The increase in 90-day prescriptions could enhance patient adherence to statin therapy, leading to better management of cardiovascular risk factors. Furthermore, the intervention significantly reduced disparities in medication access based on race and income. This evidence underscores the power of behavioral science and systemic changes to improve health outcomes and promote equity in care delivery.
Link to the article: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2832105
References Mehta, M., Fanaroff, A. C., Rhodes, C. M., Xiong, A., Snider, C. K., Grenader, E. M., Harhay, M. O., Mehrabyan, N., Peifer, M. K., Volpp, K. G. M., & Delgado, M. K. (2025). Change in default prescription length and statin prescribing behavior. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2025.0185
