Patient Safety Revisited
Not too long ago I wrote a blog article entitled “Patient Safety: It’s What It’s All About!” In keeping with that idea, and in light of this week being National Pharmacy Week with the theme of “Patient Care is Our Passion,” we’re going to discuss the drug utilization review (DUR) and how it benefits the patient.
The Omnibus Budget Reconciliation Act of 1990 (OBRA-90) requires that, as a condition of participating in the state Medicaid reimbursement program, states must establish standards of practice for drug utilization review (DUR) by the pharmacist. The DUR requires a closer review of the patient profile and an override by the pharmacist indicating that the prescription is safe to dispense. A closer look at the prescribed medication may be needed if the medication may:
- Interact with existing or past medications in the patient’s profile, such as blood thinners and warfarin
- Be contraindicated because of the patient’s allergy or medical history, such as penicillin allergy, diabetes or asthma
- Be a duplicate of a similar drug prescribed in the past, such as two different migraine medications that are both narcotic.
It is nearly impossible for any pharmacist (or physician) to remember doses, adverse effects, and drug interactions for all medications. In addition, because patients may go to more than one pharmacy or more than one physician specialist, a complete medication profile may not exist. That’s where pharmacy software can help.
Pharmacy software will compare a prescription with others the patient has received to determine whether a DUR is necessary. Because most of the data entry and scanning of prescriptions into the pharmacy’s computer database will be done by you, the pharmacy technician, you will likely be the first one to see the DUR warning pop up on the computer screen. If one appears, you will then ask the pharmacist to review the prescription and the profile before you fill the medication in order to minimize a potential medication error.
Of course the potential for medication errors increases as the number of medications a patient takes increases. This is a common occurrence with many older patients. So for every prescription, a DUR may necessary.
By drawing the pharmacist’s attention to the DUR warnings, you’re helping to ensure patient safety and quality care. Especially as this is National Pharmacy Week—thank you for doing your part to keep us all healthy!