Use of computerized databases for drug therapy quality management.

Although this paper has focused primarily on use of hospital-based databases for DUE purposes, the defunct Medicare Catastrophic Coverage Act did have provisions for ongoing prospective screening for drug interactions and adverse reactions among community Medicare prescriptions. The key to the proposed system was a point-of-service system that would have linked all Medicare pharmacies to a centralized database. This database would have been used for claims processing as well as quality management purposes. Many DUE functions at this time involve labor-intensive retrospective reviews that do not directly benefit or protect the particular patient involved. The future direction of DUE activity is concurrent screening that actively protects the patient from inappropriate prescribing. Use of computerized databases to assist in that process is a necessity.