• 보건행정학회지
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• 제34권2호
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• pp.178-184
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• 2024

연구배경: 본 연구는 의료질평가지원금 drug utilization review (DUR) 평가지표 도입 전·후의 DUR 점검률 및 의약품 중복처방 예방률 변화 차이를 비교하여 DUR 평가지표의 도입과 안전한 의약품 사용 간의 효과성을 파악하고자 한다. 방법: 본 연구는 2018년 건강보험심사평가원(Health Insurance Review and Assessment Service) DUR 자료(DUR 평가지표 도입 전)와 2023년 의료질평가지원금 평가 결과 산출 자료(DUR 평가지표 도입 후)를 활용하였다. 종속변수는 DUR 평가지표로, DUR 점검률과 의약품 중복처방 예방률 지표를 활용하였다. 독립변수는 DUR 평가지표 도입 여부이며, 통제변수는 의료기관 단위변수로, 종별 구분, 설립 구분, 소재지, DUR 청구 software 업체, 병상 수를 선정하였다. 결과: DUR 평가지표 도입 전·후의 의약품 중복처방 예방률 변화 차이를 분석한 결과, DUR 평가지표 도입 전·후의 의약품 중복처방 예방률은 통계적으로 유의미한 차이가 있었으며, DUR 평가지표 도입 후 의약품 중복처방 예방률이 유의미하게 증가하였다. 결론: 본 연구의 정책적 시사점은 다음과 같다. 첫째, DUR 시스템의 지속적인 평가 진행이 필요하다. 본 연구를 통해 DUR 평가지표 도입 후 의약품 중복처방 예방률이 유의하게 증가한 것을 확인하였다. 따라서 DUR 시스템의 효과를 계속해서 검토하고 의약품 사용의 안전성을 확대하기 위해 DUR 시스템의 지속적인 평가 진행이 필요할 것으로 판단된다. 둘째, DUR 시스템 정보를 활용하는 의료기관과 이를 관리하는 기관과의 협력 파트너십 구축이 필요하다. 의료기관의 적극적인 DUR 점검 참여와 관리기관의 다각적인 지원을 바탕으로 공동의 노력과 협력이 이루어진다면, DUR 시스템의 활성화를 통해 안전한 의약품 사용을 보장하고 국민건강을 보호하며, 의료의 질적 수준 향상을 불러올 것으로 판단된다.

• 한국임상약학회지
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• 제21권1호
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• pp.14-21
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• 2011

Drug Utilization Review (DUR) is known to play an important role to improve appropriateness of drug prescriptions. This retrospective, observational study was conducted to compare prescription patterns after installation of Computerized DUR Program (Drug Information Framework-$Korea^{TM}$) (Jan-Mar 2008; After) to before DUR program (Jan-Mar 2007: Before). 8 physicians affiliated in the S University Hospital were enrolled in the study and their 3 months' prescription data were analysed for drug prescription trends and DUR conflict events per 7 DUR screening modules (drugdrug interaction, therapeutic duplication, allergy, dosing, disease contra-indication, geriatric contra-indication, pediatric contra-indication). Average rate of DUR modules usage in 2008 (After) were 0.72. Average number of prescription drug per patient were reduced from 5.6 (Before) to 3.8 (After), and DUR program seemed to effect positively on physician's prescription related decision process. Overall DUR conflict events occurred by 8 physicians for 3 months were 17,923 Before and 20,057 After DUR program, and DUR conflict events per prescription were 2.8 Before and 2.9 After, respectively. Therapeutic duplication (37%), geriatric contra-indication (34%) and dosing (18%) were high ranked DUR conflicts. As the study was not sufficient to show a consistent trend to reduce DUR conflicts After, another study to confirm it's effectiveness would be recommended. This study would be of help to develop awareness of DUR program to healthcare providers.

• 대한산업공학회지
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• 제39권1호
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• pp.20-29
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• 2013

Medical errors such as adverse drug event, improper transfusion, wrong-site surgery, mistaken patient identity and so on commonly occur at health care practice. Information technology, like Drug Utilization Review(DUR) system which reviews, analyzes, and interprets medication data when prescribing, can play a key role in reducing such medical errors and improving patient safety. Korean Government has guided all hospitals to implement concurrent DUR(cDUR) system, which is the first case worldwide in that all healthcare providers have to use cDUR system when prescribing. This paper introduced a case study that a tertiary hospital has integrated the cDUR system into its comprehensive Hospital Information System(HIS) and analyzed the whole prescription data during a week right after adoption of cDUR system. Considering technical strength and weakness, the cDUR system was integrated into the HIS, using Broker Servers for minimizing doctors' anxiety. As the quantitative analysis of the whole prescription data, DUR conflict events, which mainly included duplicate medications and contra-indicated drug interactions for outpatients, were 2.77%. Although only 0.7% is for the contra-indicated drug interactions, it will be greatly devoted to achieve the purpose of DUR such as improving patient safety.

• 한국임상약학회지
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• 제31권2호
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• pp.104-114
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• 2021

Objective: To explore the perception of drug utilization review (DUR) system and DUR modernization pilot project among healthcare professionals and patients. Methods: We conducted 8 times of focus group interviews (FGI) between August 1, 2019 to December 31, 2019. The healthcare professionals and patients who participated in the DUR modernization pilot project were included in the present study. Based on the type of project participation or medical institution, the participants were divided into the following four groups: group 1, hospital; group 2, clinic; group 3, pharmacy; and group 4, patient. Within each group, interviews were conducted under a pre-defined agenda to identify the implicit perceptions of the participants; the contents of the interviews were, then, categorized. Results: Healthcare professionals established a consensus on the positive aspects of the DUR system and DUR modernization pilot project. However, substantial concerns remain, such as additional workload associated with monitoring adverse events or acquiring consents from patients. Furthermore, a difference of opinion over the DUR convenience system was observed. Among 3 DUR convenience system, the personal medication history review service was highly utilized, but pop-up hold function and communication system was rarely used. Conclusion: We observed that systematic intervention using the DUR system is effective for both healthcare providers and consumers. Adverse events caused by inappropriate drug use can be prevented by continuous patient monitoring. Therefore, the role of DUR system needs to be expanded to establish a safe drug management system.

• 약학회지
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• 제53권6호
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• pp.368-376
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• 2009

DUR (Drug Utilization Review) originally referred to the evaluation of drug usage details: however DUR refers to the system used to support the services of prescribing and dispensing through linking from Health Insurance Review and Assessment (HIRA) Service in Korea. HIRA is going to begin the DUR enforcement for extending to nationwide coverage after pilot test. Objectives: The aims for this study were to evaluate and clarify the current opinions of the pharmacists for the recognition and acceptance rates before nationwide coverage concerning DUR system. Methods: A 16-question-questionnaire was developed and pilot tested. For 40 days of survey by both on-line and fax paper, it was carried out on 80 pharmacists working at community pharmacy in Goyang-si, Gyeonggi-do. Results: Most of answers were broadly positive and interested in begining the DUR system and kept in mind that the goal of DUR is safety guarantee for people. On the other hand, most of answerers worry that delay of patient waiting time and inharmonious communication with doctors in DUR processing can be a major obstacle to begin the DUR system. Conclusion: To solve several problems, the most important things are to make good reciprocal relationships between doctors and pharmacists, investigate intervention tool to shorten patient waiting time, and activate educational program of inspecting items for the pharmacists.

• 약학회지
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• 제55권3호
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• pp.173-184
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• 2011

The purpose of this study was to review foreign retrospective Drug Utilization Review(DUR), and so to suggest a development plan suitable for use with domestic situation. Literature review of foreign retrospective DUR program and domestic project such as DUR and prescribing analysis project were reviewed. To improve prescribing quality, developed countries such as US, Canada, UK, France, and Australia have implemented various forms of policy. Based on the review of foreign retrospective DUR program, we suggested to apply practical implementation of retrospective DUR program.

• 말소리와 음성과학
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• 제12권3호
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• pp.25-32
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• 2020

본 연구는 영어 발화에 나타난 7가지 감정들(calm, happy, sad, angry, fearful, disgust, surprised)을 분석하고자 감정발화(672개)와 감정중립 발화(48개)와의 운율적 거리를 측정하였다. 이를 위해 외국어 발음평가에 사용되었던 방법을 적용하여 음의 높낮이(Hz), 음의 강도(dB), 음의 길이(sec)와 같은 운율의 3요소를 유클리디언 거리로 계산하였는데 기존연구에서 더 나아가 유클리디언 거리계산 정규화 방법, z-score 방법 그리고 z-score 정규화 방법을 추가해 총 4가지 그룹(sqrF0, sqrINT, sqrDUR; norsqrF0, norsqrINT, norsqrDUR; sqrzF0, sqrzINT, sqrzDUR; norsqrzF0, norsqrzINT, norsqrzDUR)의 방법을 분석에 사용하였다. 그 결과 인지적 측면과 음향적 측면의 분석 모두에서 유클리디언 운율거리를 정규화한 norsqrF0, norsqrINT, norsqrDUR이 일관성 있게 가장 효과적인 측정방법으로 나타났다. 유클리디언 거리계산 정규화 방법으로 감정발화와 감정중립 발화를 비교했을 때, 전반적으로 감정에 따른 운율의 변화는 음의 높낮이(Hz)가 가장 크고 그다음 음의 길이(sec), 그리고 음의 강도(dB)가 가장 작게 나타났다. Tukey 사후검증 결과 norsqrF0의 경우 calm

• 보건행정학회지
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• 제24권2호
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• pp.120-127
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• 2014

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.

• 한국임상약학회:학술대회논문집
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• 한국임상약학회 2003년도 추계학술대회
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• pp.29-47
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• 2003

• 대한임상약리학회:학술대회논문집
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• 대한임상약리학회 2003년도 춘계 Symposioum
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• pp.5-12
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• 2003