A primer on drug utilization review.

Many health care organizations evaluate drug utilization to improve the quality of patient care, reduce pharmaceutical expenditures, and enhance therapeutic outcomes. The Drug Regimen Review, instituted in 1974 as part of a quality assurance program for the care of Medicaid recipients, has reduced medication use, medication errors, adverse drug reactions, and drug-drug interactions. The Drug Usage Evaluation, a sophisticated analysis of drugs, their uses, and their contributions to various patient outcomes, is performed by member institutions of the Joint Commission on Accreditation of Healthcare Organizations. The 1990 Omnibus Budget Reconciliation Act (OBRA '90) established the Drug Utilization Review (DUR), which was implemented by state Medicaid outpatient prescription programs in 1993. Pharmacists performing DURs must review past patterns of drug misuse, monitor current therapy, and offer patient counseling. Drug utilization reviews have reduced inappropriate drug use and decreased drug costs.