Drug Utilization Review

Written by Patricia Tunstall
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Created by the Omnibus Budget Reconciliation Act (OBRA) of 1990, the Medicaid Drug Utilization Review (DUR) must be implemented in every state. In general, this DUR is intended to set up a comprehensive monitoring and analysis of the prescription drug program. Specifically, each state was encouraged by expanded federal funding to design and install electronic management systems for their drug programs.

DUR and Patient Safety

The ultimate goal of OBRA is the promotion of patient safety through the establishment of an effective review structure that examines all stages of prescribing drugs to outpatients. "Patient safety" means that outpatients are given appropriate medicine for their immediate medical condition with consideration of their medical history. Is the medicine medically necessary? Does it avoid potential problems by taking into account patient allergies and past reactions to drugs?

There is growing awareness among the public, among medical organizations, and among health departments in the federal government of the urgent need for reform of the nation's medication dispensing system. Technology is recognized as the basis for an overhaul of this archaic system, because with electronic oversight of prescription writing comes greatly reduced errors from all sources. Through increasing awareness of drug formularies, patient medical history, and drug interactions, for example, Medicaid programs hope to enhance patient health care.

Hospitals and other health institutions have their own DUR, of course, to ensure proper drug therapy for patients. Often, hospitals are better organized to utilize electronic medical systems for better care, and their DUR programs reflect this. Their programs are designed to be comprehensive examinations of planning, data collection and evaluation, intervention, and program evaluation.


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