• YAKHAK HOEJI
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• v.53 no.3
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• pp.138-144
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• 2009

The purpose was to implement drug utilization review (DUR) for whom were diagnosed with chronic kidney disease (CKD) population using health insurance claim data. This study constructed drug utilization database using Health Insurance Review and Assessment Service (HIRA) database and selected contraindicated drugs with kidney based on previously developed drug utilization guide and reviewing other countries' examples. Main outcome measures were the proportion of prescription for 1 or more drugs of concern. The cohort included 115,948 subjects, who were diagnosed with chronic kidney disease. Inappropriate drugs with CKD patients was some used, and the most commonly prescribed classes were aluminum drugs. However it is difficult to find problems with inappropriate drug because claims data doesn't have laboratory data. Based on the result of retrospective drug utilization review study, more studies should be analysed drug utilization patterns and monitoring system should be developed.

• Korean Journal of Clinical Pharmacy
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• v.29 no.1
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• pp.9-17
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• 2019

Objective: The objective of the present study was to evaluate the effects of implementing a systematic Drug Utilization Review (DUR) system on contraindicated drug use and pharmaceutical expenditures in Korea. Methods: A literature search was conducted using search engines such as PubMed, EMBASE, NDSL, and RISS for relevant systematic studies. The database search was performed and updated in April 2018. Two independent reviewers evaluated the abstracts to find potentially eligible articles. Results: In total, 1433 potentially eligible studies were selected, and 11 articles were eventually shortlisted for inclusion in the present review system. The outcome showed that contraindicated drug use decreased after implementation of the DUR system in Korea. The analysis also showed that the DUR system contributed to a reduction in pharmaceutical expenditures. Conclusions: Our study showed that implementing the DUR system reduced both contraindicated drug use and pharmaceutical expenditures in Korea.

• 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.

• The Journal of the Korea Contents Association
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• v.19 no.1
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• pp.234-241
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• 2019

The side effects of using drugs can greatly threaten the health of the public. The reality is that there are very few reports of current side effects. This can be activated by linking adverse drug reactions reporting to the Drug Utilization Review (DUR) currently used by pharmacies. A study of the U.S. medication management system, where drug use assessment is activated, can find ways to activate adverse drug reactions reporting. In 'Pharm IT 3000', which is used as a medication management program in pharmacies, we examined how to enable reporting of adverse drug reactions. The literature study and research on actual program operation have found a convenient way to report side effects by linking the Pharm IT 3000 prescription preparation assessment to the item.

• 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.

• 대한임상약리학회:학술대회논문집
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• 2003.06a
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• pp.25-25
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• 2003

• 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.

• Health Policy and Management
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• v.22 no.4
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• pp.561-578
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• 2012

This study was performed in order to compare a change in pharmaceutical expenditures per outpatient of clinic and to analyze factors relevant to a systems as part of evaluating policies for the incentive scheme to reduce total prescribed drug expenditure and for the drug utilization review system("DUR system" hereafter). For this, it had finally analytical subjects as 21,320 clinics nationwide without a change in location, clinics symbol and signed subject during both terms of the first half of 2010 and the first half of 2011. As a result, the odds ratio with reduction in pharmaceutical expenditures of clinic was statistically higher significantly in the shorter year number of opening clinic, in the larger number of doctors, when the classification of establishment is other, not individual, and when the signed subject is surgical division. Also, the odds ratio was significantly higher in the less patient number of clinic and in the lower ratio of patients aged over 65. Finally, the odds ratio was significantly high when a clinic had been located in DUR system demonstrative project area. Through this, a case of policy for improvement in doctor's autonomous prescription behavior like DUR system can be known to be effective for reduction in pharmaceutical expenditures. A future research on evaluation of policy for pharmaceutical expenditure management system will need to be performed in-depth analysis in consideration of diverse characteristics on the participatory entities.

• 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.

• Korean Journal of Clinical Pharmacy
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• v.21 no.3
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• pp.249-255
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• 2011

Objective: To examine the drug use (prescribing) pattern of serious drug-drug interactions (DDIs, contraindicated drug interactions) using real world data. Prescription patterns were examined in terms of dispensing types. Method: Retrospective drug utilization review (DUR) study was performed. One hundred and six datasets of serious DDIs (DDI pairs) were determined among DDI datasets that Ministry of Health & Welfare announced for the DUR system from 2004 to 2005. Electronically transacted ambulatory patients' prescription database to Health Insurance Assessment and Review Services (HIRA) from July, 2005 to June, 2006 was collected with personal information deidentified and analyzed in terms of types of dispensing as a contributing factor. Results: After prescription data analysis per each patient, total number of DDI cases using 95 DDI pairs was 5,511, which accounted for 2.6 cases per patients. DDI cases between two drugs from each of community pharmacy dispensing- type prescription were considerable (63% vs. 24% in those from each of in-institutional dispensing-type prescription and vs. 13% in those from a community pharmacy dispensing-type prescription and an in-institutional dispensingtype prescription). Conclusions: DDI cases from different prescribers were found to be significant. Thus, the concurrent DUR process between prescriptions from different physicians and institutions should be implemented for the safe drug use.