West S K, Brandon B M, Stevens A M, Zauber A, Chase G, Stolley P D, Rumrill R E
Med Care. 1977 Jun;15(6):505-14. doi: 10.1097/00005650-197706000-00007.
An experimental drug utilization review program was developed for a health maintenance organization (HMO). The objectives of the program were to develop and implement an ongoing mechanism for reviewing drug use using criteria based on the scientific literature, and to evaluate the effect of the drug use review program on physician precribing patterns. Seven therapeutic categories of drugs, accounting for over 65 per cent of prescribing, were selected and criteria developed for their use. The drug use review prcedure is described briefly. The evaluation of the drug use review program is based on a comparison of rates of prescription use for specific therapeutic categories before and after the criteria were ceveloped and approved. As an example, data for the antihistamine therapeutic category are presented. Criteria for prescribing antihistamines suggested restricting use of combination cold preparations and refraiming from antihistamine use in viral upper respiratory tract infections. After the criteria were adopted, prescribing of antihistamines for viral URIs declined, particularly in pediatrics. In general, prescribing of combination antihistamine preparations did not change; where one combination preparation was deleted from the formulary, prescribers appeared to substitute another combination preparation.
为一家健康维护组织（HMO）开发了一个实验性药物使用审查项目。该项目的目标是建立并实施一种持续机制，使用基于科学文献的标准来审查药物使用情况，并评估药物使用审查项目对医生处方模式的影响。选择了占处方量超过65%的七个治疗类别的药物，并为其使用制定了标准。简要描述了药物使用审查程序。药物使用审查项目的评估基于在标准制定和批准前后特定治疗类别药物处方使用率的比较。作为一个例子，给出了抗组胺药治疗类别的数据。抗组胺药的处方标准建议限制复方感冒药的使用，并避免在病毒性上呼吸道感染中使用抗组胺药。在采用这些标准后，用于病毒性上呼吸道感染的抗组胺药处方量下降，尤其是在儿科。总体而言，复方抗组胺药制剂的处方量没有变化；当一种复方制剂从处方集里删除时，开处方者似乎会改用另一种复方制剂。
