Heo Ji Haeng, Suh Dong Churl, Kim Sukil, Lee Eui-Kyung
School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, South Korea.
College of Pharmacy, Chung-Ang University, Seoul, South Korea.
Int J Med Inform. 2013 Oct;82(10):987-95. doi: 10.1016/j.ijmedinf.2013.07.001. Epub 2013 Jul 30.
A pilot drug utilization review (DUR) program was initiated by the Korean government, which provided safety information in real-time at the stage of prescribing and dispensing. This study aimed to compare the "physician/pharmacist Co-DUR" system and the traditional "pharmacist-only DUR" system.
Data collected during a DUR pilot program from July 1 to October 31 of 2009 were obtained from the Health Insurance Review & Assessment Service. Descriptive analyses were conducted to investigate DUR-pop up alert rates, categories of alerts, the reasons for dispensing without prescription change after an alert, and changes in drug expenditures associated with the DUR.
DUR pop-up alert rates were 8.55% at clinics and 1.90% at pharmacies in the physician/pharmacist Co-DUR, whereas the rate was 2.22% in the pharmacist-only DUR. Rates of pop-up alerts were high for between-prescription ingredient duplication at pharmacies, whereas for clinics, the rate for drug-pregnancy contraindications was high. A greater reduction in drug expenditure was estimated in the physician/pharmacist Co-DUR compared to the pharmacist-only DUR.
The physician/pharmacist Co-DUR has better sensitivity at detecting potential adverse drug events than the pharmacist-only DUR. Pharmacists also have opportunities to double-check prescribed drugs when doctors do not voluntarily modify pop-up alerts. Further comprehensive study will be needed to confirm the results of pilot program that favored the physician/pharmacist Co-DUR.
韩国政府启动了一项试点药物利用审查(DUR)计划,该计划在处方和配药阶段实时提供安全信息。本研究旨在比较“医生/药剂师联合药物利用审查”系统和传统的“仅药剂师药物利用审查”系统。
从健康保险审查与评估服务机构获取了2009年7月1日至10月31日DUR试点项目期间收集的数据。进行描述性分析以调查DUR弹出警报率、警报类别、警报后未更改处方仍进行配药的原因以及与DUR相关的药物支出变化。
在医生/药剂师联合药物利用审查中,诊所的DUR弹出警报率为8.55%,药房为1.90%,而在仅药剂师药物利用审查中该率为2.22%。药房中处方间成分重复的弹出警报率较高,而诊所中药物妊娠禁忌的警报率较高。与仅药剂师药物利用审查相比,医生/药剂师联合药物利用审查估计药物支出减少幅度更大。
与仅药剂师药物利用审查相比,医生/药剂师联合药物利用审查在检测潜在药物不良事件方面具有更好的敏感性。当医生未主动修改弹出警报时,药剂师也有机会对处方药进行二次检查。需要进一步进行全面研究以确认支持医生/药剂师联合药物利用审查的试点项目结果。