DOI QR코드

DOI QR Code

The Effect of Korean Prospective Drug Utilization Review Program on the Prescription Rate of Drug-Drug Interactions

의약품 처방·조제지원서비스(Drug Utilization Review)사업이 병용금기 처방률에 미치는 영향

  • Received : 2014.03.24
  • Accepted : 2014.06.17
  • Published : 2014.06.30

Abstract

Background: Since December 2010, online computerized prospective drug utilization review (pDUR) has been implemented in Korea. pDUR involves the review of each prescription before the medication is dispensed to the individual patient. The pDUR is performed electronically by Health Insurance Review & Assessment Service (HIRA), which is a Korean governmental agency, and then HIRA provides medical institutions and pharmacies with information that can be helpful to them in preventing potential drug problems such as drug/drug interactions or ingredient duplication. The aim of this study was to assess the impact of the Korean pDUR implementation on the proportion of drug-drug interactions (DDIs) using claims data from HIRA. Methods: A before-after comparison of the prevalence of DDIs between prescription was conducted, using HIRA administrative claims data of medical institution from January 2010 to December 2011. The analysis unit was the prescription issued and pairs before and after. The main outcome measures were the proportion of DDIs within- (control group) or between- physician encounters. To examine the difference, a paired t-test was applied. Results: We found that DDIs proportion between prescription decreased significantly (t=3.04, p=0.0026) after the implementation of pDUR, whereas there is no significant reduction within prescription (t=1.15, p=0.2518). With respect to the prevalence of DDIs between drug groups, the most dramatic reduction was occurred between 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors and anti-fungal agents. Conclusion: It seems effective that giving a direct feedback to prescribers by a prospective DUR. Further research is needed to assess the impact of DUR to final outcomes such as hospitalization.

Keywords

Drug utilization review;Drug interaction;Prescription

References

  1. Malone DC, Hutchins DS, Haupert H, Hansten P, Duncan B, Van Bergen RC, et al. Assessment of potential drug-drug interactions with a prescription claims database. Am J Health Syst Pharm 2005;62(19):1983-1991. https://doi.org/10.2146/ajhp040567
  2. Bates DW, Leape LL, Cullen DJ, Laird N, Petersen LA, Teich JM, et al. Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. JAMA 1998;280(15):1311-1316. https://doi.org/10.1001/jama.280.15.1311
  3. Armstrong EP, Markson TJ. On-line DUR messages: pharmacists' attitudes and actions in response. J Am Pharm Assoc (Wash) 1997;NS37(3): 315-320.
  4. Aparasu R, Baer R, Aparasu A. Clinically important potential drug-drug interactions in outpatient settings. Res Social Adm Pharm 2007;3(4):426-437. https://doi.org/10.1016/j.sapharm.2006.12.002
  5. Peng CC, Glassman PA, Marks IR, Fowler C, Castiglione B, Good CB. Retrospective drug utilization review: incidence of clinically relevant potential drug-drug interactions in a large ambulatory population. J Manag Care Pharm 2003;9(6):513-522.
  6. Walsh KE, Landrigan CP, Adams WG, Vinci RJ, Chessare JB, Cooper MR, et al. Effect of computer order entry on prevention of serious medication errors in hospitalized children. Pediatrics 2008;121(3):e421-e427. https://doi.org/10.1542/peds.2007-0220
  7. Lee HY, Kwon YJ. A study on rebates in the pharmaceutical industry from the perspective of new institutionalism. Korean J Health Policy Admin 2011;21(1):132-157. https://doi.org/10.4332/KJHPA.2011.21.1.132
  8. Kim JJ. Gumgicheobang haenoko yeawhaesayunun 'kukuku' [Physicians prescribe contraindication drugs with meaningless reason description in DUR program]. Dailypharm. 2012 Apr 23.
  9. Kim JE. DUR chamyeoyul 98.6%, meomchooji annun gumgiyack cheobang [Rate of DUR participation is 98.6%, contraindication drugs keep prescribing without a stop]. Dailypharm. 2012 Oct 16.
  10. Kwon SM, Choi SE, Song JG, Son CW, Im EA, Kang TW, et al. The study of evaluation of DUR demonstration project including over-the-counter drugs in Jeju Island [report]. Seoul: Seoul National University; 2010.
  11. Armstrong EP, Denemark CR. How pharmacists respond to on-line, real-time DUR alerts. J Am Pharm Assoc (Wash) 1998;38(2):149-154. https://doi.org/10.1016/S1086-5802(16)30314-X
  12. Chui MA, Rupp MT. Evaluation of online pDUR programs in community pharmacy practice. J Manag Care Pharm 2000;6(1):27-32.
  13. Grizzle AJ, Mahmood MH, Ko Y, Murphy JE, Armstrong EP, Skrepnek GH, et al. Reasons provided by prescribers when overriding drug-drug interaction alerts. Am J Manag Care 2007;13(10):573-578.
  14. Monane M, Matthias DM, Nagle BA, Kelly MA. Improving prescribing patterns for the elderly through an online drug utilization review intervention: a system linking the physician, pharmacist, and computer. JAMA 1998;280(14):1249-1252. https://doi.org/10.1001/jama.280.14.1249
  15. Shah NR, Seger AC, Seger DL, Fiskio JM, Kuperman GJ, Blumenfeld B, et al. Improving acceptance of computerized prescribing alerts in ambulatory care. J Am Med Inform Assoc 2006;13(1):5-11. https://doi.org/10.1197/jamia.M1868
  16. Paterno MD, Maviglia SM, Ramelson HZ, Schaeffer M, Rocha BH, Hongsermeier T, et al. Creating shareable decision support services: an interdisciplinary challenge. AMIA Annu Symp Proc 2010;2010:602-606.
  17. Ernst FR, Grizzle AJ. Drug-related morbidity and mortality: updating the cost-of-illness model. J Am Pharm Assoc (Wash) 2001;41(2):192-199. https://doi.org/10.1016/S1086-5802(16)31229-3
  18. Bates DW, Cullen DJ, Laird N, Petersen LA, Small SD, Servi D, et al. Incidence of adverse drug events and potential adverse drug events: implications for prevention. ADE Prevention Study Group. JAMA 1995;274(1): 29-34. https://doi.org/10.1001/jama.1995.03530010043033
  19. Kohn LT, Corrigan J, Donaldson MS; Institute of Medicine. To err is human: building a safer health system. Washington (DC): National Academy Press; 2001.
  20. Jha AK, Kuperman GJ, Rittenberg E, Teich JM, Bates DW. Identifying hospital admissions due to adverse drug events using a computer-based monitor. Pharmacoepidemiol Drug Saf 2001;10(2):113-119. https://doi.org/10.1002/pds.568
  21. Leape LL, Bates DW, Cullen DJ, Cooper J, Demonaco HJ, Gallivan T, et al. Systems analysis of adverse drug events. ADE Prevention Study Group. JAMA 1995;274(1):35-43. https://doi.org/10.1001/jama.1995.03530010049034
  22. Fulda TR, Lyles A, Pugh MC, Christensen DB. Current status of prospective drug utilization review. J Manag Care Pharm 2004;10(5):433-441.
  23. Wertheimer AI. Quality control and drug utilization review. Pharm Weekbl Sci 1988;10(4):154-157. https://doi.org/10.1007/BF01959424
  24. Erwin WG. The definition of drug utilization review: statement of issues. Clin Pharmacol Ther 1991;50(5 Pt 2):596-599. https://doi.org/10.1038/clpt.1991.188
  25. Choi ET. DUR jumgum wall 8900gun...99% soyosigan 1choyinae [Monthly DUR case is 89 million...99% of cases take less than 1 second]. Dailypharm. 2012 Apr 3.
  26. Choi ET. DUR itsumyeon meohae, sayongjoongjiyack algodo cheobangjojae [Despite the presence of DUR, providers are still prescribing and dispensing withdrawal drugs even though they know the drugs]. Dailypharm. 2012 Sep 12.
  27. Kim JE. DUR chamyeoyul 98.6%, meomchooji annun gumgiyack cheo bang [Rate of DUR participation is 98.6%, contraindication drugs keep prescribing without a stop]. Dailypharm. 2012 Oct 16.

Cited by

  1. Between government policy, clinical autonomy, and market demands: a qualitative study of the impact of the Prescribing Analysis System on behavior of physicians in South Korea vol.15, pp.1, 2015, https://doi.org/10.1186/s12913-015-1059-x
  2. New Alert Override Codes for the Drug Utilization Review System Derived from Outpatient Prescription Data from a Tertiary Teaching Hospital in Korea vol.22, pp.1, 2016, https://doi.org/10.4258/hir.2016.22.1.39
  3. Effect of providing drug utilization review information on tricyclic antidepressant prescription in the elderly vol.42, pp.10, 2018, https://doi.org/10.1007/s10916-018-1061-z