Pre-OBRA '90 Medicaid survey: how community pharmacy practice is changing.

Medicaid pharmacy providers in Virginia were surveyed to estimate the potential impact of the Omnibus Budget Reconciliation Act of 1990, which mandated prospective drug use review (DUR) beginning January 1, 1993. The data measure which DUR activities were being performed by pharmacists before the law took effect, and the survey compares and contrasts these data with the activities mandated by full compliance with the law. Many respondents already perform several of the required DUR activities, and nearly all agree that full compliance requires more time to process each prescription order. Barriers to full compliance include lack of time to counsel patients adequately, lack of patient-specific information, and no compensation for offering clinical/cognitive services.