Development and implementation of a comprehensive, criteria-based drug-use review program.

Area of Science:

• Health Services Research
• Pharmacoeconomics
• Clinical Pharmacy

Background:

• Hospitals require systematic drug-use evaluation to ensure cost-effectiveness and quality of care.
• Established criteria are essential for guiding appropriate medication selection and utilization.
• The Pharmacy and Therapeutics (P&T) committee plays a crucial role in overseeing drug policies and formulary management.

Purpose of the Study:

• To describe a comprehensive drug-use review (DUR) program designed for cost-effective drug therapy.
• To meet the Joint Commission on Accreditation of Hospitals standards for drug-use evaluation.
• To integrate P&T committee decisions into daily pharmacy practice.

Main Methods:

• Formation of antibiotic and ambulatory-care drug-use subcommittees with multidisciplinary representation.
• Monthly review of overall drug-use patterns and investigation of specific problem drugs.
• Implementation of a mandatory antibiotic order form, pharmacy computer systems, and monitoring of nonformulary drug use.
• Modification of the formulary process to require submission and adoption of specific drug-use criteria.

Main Results:

• Successful curtailment of inappropriate drug use.
• Significant reduction in overall drug expenditures.
• Effective integration of P&T committee decisions into daily pharmacy operations.
• Enabled ongoing, systematic, criteria-based drug-use evaluations by the P&T committee.

Conclusions:

• The described drug-use review program effectively promotes cost-effective drug therapy.
• The program facilitates adherence to hospital accreditation standards for drug evaluation.
• Systematic, criteria-based reviews enhance the P&T committee's ability to manage drug use effectively.