Lee Seung-Mi, Lee Soo-Ok, Kim Dong-Sook
Chung-Ang University College of Pharmacy, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Republic of Korea.
Health Insurance Review and Assessment Service, 60 Hyeoksin-ro, Wonju-si, Gangwon-do 26465, Republic of Korea.
Int J Qual Health Care. 2017 Oct 1;29(5):634-641. doi: 10.1093/intqhc/mzx085.
To identify healthcare providers' experience and satisfaction for the drug utilization review (DUR) system, their impact on prescription changes following alerts, and difficulties experienced in the system by surveying primary healthcare centers and pharmacies.
A cross-sectional nationwide survey.
Approximately 2000 institutions were selected for the survey by a simple random sampling of nationwide primary healthcare centers and community pharmacy approximately practices, and 358 replied.
The questionnaire included questions on experience and recognition of DUR alerts, personal attitude and respondents' biographical information. Space was included for respondents to suggest improvements of the DUR system.
The DUR system scored 71.5 out of 100 points for satisfaction by physicians and pharmacists, who reported that the alerts prevent medication-related errors; most respondents (96.6%) received the alerts. Several respondents (10.9%) replied that they prescribe or dispense prescriptions as they are without following the alerts. Physicians (adjusted odds ratio, 8.334; 95% confidence interval, 3.449-20.139) are more likely to change the prescription than pharmacists and persons with alert experience (4.605; 1.080-19.638). However, current practice in metropolitan areas (0.478; 0.228-1.000) and frequent alerts regarding co-administration incompatibilities within prescriptions (0.135; 0.031-0.589) negatively influence adherence to DUR alerts.
Although most surveyed physicians and pharmacists receive the alerts, some do not or reported that they would not follow the alerts. To increase adherence, the DUR system should be improved to ensure a preferential and intensive approach to detecting potentially high-risk drug combinations.
通过对基层医疗中心和药店进行调查，了解医疗服务提供者对药物利用审查（DUR）系统的体验和满意度、警报对处方变更的影响以及该系统中遇到的困难。
一项全国性横断面调查。
通过对全国基层医疗中心和社区药房大约2000家机构进行简单随机抽样选取参与调查对象，358家机构进行了回复。
问卷包括关于对DUR警报的体验和认知、个人态度以及受访者个人信息的问题。问卷还为受访者留出空间，以便他们提出对DUR系统的改进建议。
医生和药剂师对DUR系统的满意度得分为71.5分（满分100分），他们报告称警报可预防与用药相关的错误；大多数受访者（96.6%）收到了警报。一些受访者（10.9%）回复称他们按处方开药或配药时未遵循警报。医生（调整优势比，8.334；95%置信区间，3.449 - 20.139）比药剂师和有警报体验者（4.605；1.080 - 19.638）更有可能更改处方。然而，大城市地区的当前做法（0.478；0.228 - 1.000）以及处方内联合用药不相容性的频繁警报（0.135；0.031 - 0.589）对遵循DUR警报产生负面影响。
尽管大多数接受调查的医生和药剂师收到了警报，但一些人未收到或表示不会遵循警报。为提高遵循率，应改进DUR系统，以确保采用优先和强化的方法来检测潜在的高风险药物组合。
