[포스터] Drug Utilization Review(DUR)를 통한 병용금기 약물 처방에 대한 평가 및 고찰
2019년 추계학술대회 초록
- Hwanryeol Kimo, Sunyoung Min, Sumi Yu, Younjoo Jung, Hyokeun Jeong
Department of Pharmacy, VHS medical center, Korea Veterans Health Service
- Drug utilization Review, drug-drug interaction, contraindicated medications, incomparable drugs
[Purpose] Drug Utilization Review(DUR) notifies alerts to clinician and pharmacist when contraindicated drugs have been prescribed and dispensed. If clinician want to override alerts, must input reasons for not change. Pharmacist dispense prescription and inform patients using reasons provided by clinician. The purpose of this study is to confirm cases which contraindicated drugs have been prescribed overriding alerts, and to investigate prescriber’s reasons for overriding drug-drug interaction alerts.
[Methods] This study investigated outpatient cases where contraindicated medications with drug-drug interaction were prescribed and administered unaltered, through the Drug Utilization Review(DUR), using the Electronic Medical Record (EMR), at this center from January 1, 2018 to June 30, 2018. Prescriptions of identical medications for the same patient, prescribed in a different day, were regarded as a different case, due to having a different reason for issuing a prescription.
[Results] A total of 514 cases of prescriptions having contraindicated medications of drug-drug interaction were confirmed. The grounds for prescribing 514 cases of contraindicated medications include 1) Unadministered contraindicated medications (220 cases, 42.8%), 2) Drugs are taken intermittently or Pro Re Nata(PRN) (147, 28.6%), 3) Administered by a clinical decision (79, 15.4%), 4) Local administration (21, 4.1%), 5) Meangless words(44, 8.6%), 6) Emergency medication (3, 0.6%). The reasons for prescribing contraindicated medications with drug-drug interaction in cases of Anti-diabetic agent with CT contrast medium were as follows: Unadministered contraindicated medications(95 cases, 76.0%), Meangless words(22, 17.6%), Administered by a clinical decision(8, 6.4%). Reasons for Other genitourinary organ and rectal agent with Vasodilator were PRN (54 cases, 38.3%), Administered by a clinical decision (42, 29.8%), Unadministered contraindicated medications (29, 20.6%), and Meangless words (16, 11.3%). Reasons for NSAID with other cardiovascular drugs were PRN(65 cases, 69.9%), Unadministered contraindicated medications (16, 17.2%), and Local administration (13, 28.9%).
[Conclusion] We confirmed that certain medications were sometimes prescribed using an incorrect reason. Some clinician input a reason that is something other than a PRN drug use, or entered a meaningless word. It is necessary to improve the system of entering the reasons why clinicians prescribe contraindicated drugs.
- P-28. 김환렬(보훈공단 중앙보훈병원).pdf