ProDUR Introduction

Question 1

DUR Definition

Answer 1

Drug Utilization/Use Review

Question 2

DUE/MUE Definition

Answer 2

Drug/Medication Utilization/Use Evaluation

Question 3

Type of DUR: Prospective, Concurrent, Retrospective

Answer 3

• Prospective
  
  • Review of appropriateness of a medication order PRIOR to dispensing
• Concurrent
  
  • Monitoring a patient’s outcomes while on therapy
• Retrospective
  
  • Review of appropriateness AFTER medication was prescribed

Question 4

Why conduct ProDUR?

Answer 4

• Ensure that medication order will be safe and appropriate for patient (and legal)
• OBRA 90!
• WA law says have to do it for everyone

Question 5

Examples of problems ID’d in ProDUR

Answer 5

• Wrong drug
• Wrong dose (ie, strength and/or frequency
• Wrong route
• Wrong length of therapy
• Drug interactions

Question 6

DUR messages: What are they and how reliable are they?

Answer 6

• Computerized alerts that pop up during Rx input
• Not very reliable: ALWAYS use your knowledge and don’t rely on the computer!

Question 7

Steps in ProDUR

Answer 7

1. Obtain patient info
2. Assess completeness and technical aspects of order
3. Assess clinical appropriateness of order for patient

Question 8

Patient Info: ID/Technical Info

Answer 8

• —is this Rx for you??
• —have you had prescriptions filled here before?
• —DOB, MI, correct spelling of name, sex
• —address, phone #, insurance info
• —Other (eg, generic only, EZ-open caps, etc)

Question 9

Patient Info: Medical Info

Answer 9

• —allergies (what kind and what Rxn? Drugs, food, etc)
• —current medical conditions (eg, diabetes, HTN, pregnancy)
• — Other medications (eg, Rx, herbals, supplements, non-Rx)
• —Misc (eg, odd rxns, etc)

Question 10

Completness and Technicalities

Answer 10

• Is the prescription legitimate and have all the legal requirements?
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Type of prescriber?

* to determine if prescriber is prescribing within his/her scope of practice  * ​Inventory? Formulary? 
* ​Is it in stock? Is it covered by patients insurance?

Question 11

Clinical Appropriateness

Answer 11

• Medication appropriate for patient (age, allergy, etc) AND diagnosis?
• —Appropriate strength + frequency for diagnosis AND patient (adherence)?
• Appropriate route for patient (contraindications?) AND drug (does it come that way)?
• Appropriate length of therapy (qty+refills) for patient (adherence) AND diagnosis?
• No intx (drug AND disease/condition)