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Updated: Oct 27, 2026

Drug Repurposing Hypothesis Generation Using the "RE:fine Drugs" System
Published on: December 11, 2016
Optimizing drug utilization review alerts and clinical decision support in community pharmacy
Gregory Lipp1, Audrea H Szabatura2, Hannah Praysman1
1Professional Services, CVS Pharmacy, CVS Health, Woonsocket, RI.
Background:
In community pharmacies, drug utilization review (DUR) clinical decision support (CDS) tools support pharmacists in their pivotal role in improving the quality of patient care activities by identifying potential medication-related problems. However, these systems often introduce their own challenges, creating an opportunity to develop a novel system that integrates patient-specific factors, leverages previously documented pharmacist interventions, and delivers actionable, evidence-based guidance tailored to the community pharmacy setting.
Objectives:
To assess the impact of an enhanced DUR CDS system on alert burden and documented pharmacist interventions.
Practice Description:
A community pharmacy organization with over 9,000 pharmacy locations throughout the United States utilizing a shared DUR CDS system.
Practice Innovation:
As part of a quality enhancement project, the pharmacy DUR CDS system was redesigned and implemented nationwide. The enhanced DUR CDS system displayed refined and aggregated alerts based on clinical consequence, incorporated patient-specific predisposing and mitigating factors as well as prior pharmacist-documented actions, and embedded actionable, evidence-based guidance aligned with community pharmacy workflows.
Evaluation Methods:
A retrospective, quantitative pre-post evaluation was conducted across more than 9,000 community pharmacies to evaluate the impact of nationwide implementation of the enhanced DUR CDS system on alert burden and pharmacist intervention. Alert burden, defined as the number of alerts per 100 prescriptions (Rxs), and pharmacist intervention, defined as the number of documented pharmacist outreaches to patients and/or prescribers per 100 Rxs, were each measured over a one-month period pre/post enhanced DUR CDS system implementation.
Results:
After implementation of the enhanced DUR CDS system, alert burden decreased 82.211% (from 141.997 to 25.260 alerts/100 Rxs) and pharmacist interventions increased 93.915% (from 5.177 to 10.039 interventions/100 Rxs).
Conclusions:
These findings suggest that improving alert relevance, presentation, and actionability may better support pharmacists' assessment of medication-related risks and facilitate patient and prescriber engagement without increasing cognitive burden, potentially leading to improved medication safety, adherence, and/or clinical outcomes.
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