• Title/Summary/Keyword: DUR

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Comparison of Drug Prescriptions Before and After Computerized Drug Utilization Review Program Installation in a Tertiary Hospital Setting (3차 의료기관에서 전산화의약품사용평가프로그램 설치 전후의 의약품처방 비교)

  • Kim, Sang-Mee;Sohn, Hyun-Soon;Shin, Hyun-Taek
    • Korean Journal of Clinical Pharmacy
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    • v.21 no.1
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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.

A Case Study of Implementation of Concurrent Drug Utilization Review System at a General Hospital (동시적 의약품 사용평가(cDUR) 시스템 구축 및 적용 사례 연구 : 국내 한 대학병원을 중심으로)

  • Choi, Jong Soo;Kim, Dongsoo
    • Journal of Korean Institute of Industrial Engineers
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    • v.39 no.1
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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.

Exploring the Perception on Drug Utilization Review System and DUR Modernization Pilot Project: A Qualitative Study Using Focus Group Interviews (DUR 제도 및 DUR 고도화 시범사업에 대한 인식 탐구: 포커스 그룹 인터뷰 기법 중심의 질적 연구)

  • Bea, Sungho;Jeon, Ha-Lim;Yoon, Dongwon;Choi, Ahhyung;Lee, Hyesung;Shin, Ju-Young
    • Korean Journal of Clinical Pharmacy
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    • v.31 no.2
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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.

A Study of Recognition and Acceptance on Pharmacists for the Enforcement of Drug Utilization Review (처방조제지원시스템 시행에 따른 약사의 인지도 및 수용성에 대한 조사)

  • Choi, Byung-Chul
    • YAKHAK HOEJI
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    • v.53 no.6
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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.

Review of the Retrospective Drug Utilization Review Program from Foreign Countries' Experience (외국의 후향적 DUR 제도 현황과 정책적 함의)

  • Kim, Dong-Sook;Kim, Su-Kyeong;Jang, Sun-Mee
    • YAKHAK HOEJI
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    • v.55 no.3
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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.

An analysis of emotional English utterances using the prosodic distance between emotional and neutral utterances (영어 감정발화와 중립발화 간의 운율거리를 이용한 감정발화 분석)

  • Yi, So-Pae
    • Phonetics and Speech Sciences
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    • v.12 no.3
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    • pp.25-32
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    • 2020
  • An analysis of emotional English utterances with 7 emotions (calm, happy, sad, angry, fearful, disgust, surprised) was conducted using the measurement of prosodic distance between 672 emotional and 48 neutral utterances. Applying the technique proposed in the automatic evaluation model of English pronunciation to the present study on emotional utterances, Euclidean distance measurement of 3 prosodic elements such as F0, intensity and duration extracted from emotional and neutral utterances was utilized. This paper, furthermore, extended the analytical methods to include Euclidean distance normalization, z-score and z-score normalization resulting in 4 groups of measurement schemes (sqrF0, sqrINT, sqrDUR; norsqrF0, norsqrINT, norsqrDUR; sqrzF0, sqrzINT, sqrzDUR; norsqrzF0, norsqrzINT, norsqrzDUR). All of the results from perceptual analysis and acoustical analysis of emotional utteances consistently indicated the greater effectiveness of norsqrF0, norsqrINT and norsqrDUR, among 4 groups of measurement schemes, which normalized the Euclidean measurement. The greatest acoustical change of prosodic information influenced by emotion was shown in the values of F0 followed by duration and intensity in descending order according to the effect size based on the estimation of distance between emotional utterances and neutral counterparts. Tukey Post Hoc test revealed 4 homogeneous subsets (calm

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)

  • Kim, Dong-Sook;Park, Juhee;Jeon, Ha-Rim;Park, Chanmi;Kang, Hyeun Ah
    • Health Policy and Management
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    • v.24 no.2
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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.

The Evaluation of Drug Utilization Review on Potentially Inappropriate Medications for Elderly Patients in a Tertiary Hospital (Drug Utilization Review 시행 전후 3차 의료기관에서의 노인주의약품 외래처방 현황 분석)

  • Cho, Yeo Hyang;Kim, Kwang Joon
    • Korean Journal of Clinical Pharmacy
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    • v.29 no.1
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    • pp.25-32
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    • 2019
  • Objective: South Korea made a list of potentially inappropriate medications (PIMs) for elderly patients in 2015 and has prompted medical professionals to prescribe proper medication by using the drug utilization review (DUR) system. It has been three years since the system was introduced, but related studies have rarely been conducted. This study aimed to evaluate the effect of the DUR system on the prescription of PIMs for elderly patients. Methods: The data on the prescription of PIMs for elderly patients (${\geq}65$ years) who received medical treatment between March 1st and May 31st in 2015 (before introduction of the DUR system) and who received medical treatment between March 1st and May 31st in 2018 (after introduction of the DUR system) were retrospectively collected from electronic medical records. Results: The prescriptions of PIMs decreased from 3,716 (7.7%) to 3,857 (6.9%) (p < 0.001). The prescription of escitalopram and paroxetine, among selective serotonin reuptake inhibitors, increased significantly, and that of short-acting benzodiazepines also increased significantly from 454 (0.93%) to 624 (1.2%). Conclusion: Prescription of PIMs for elderly patients significantly decreased (p < 0.001) after the DUR system was introduced. Further expanded studies of PIMs need to be conducted for the safety of elderly patients.