Drug therapy review as part of a medical audit process

A method of chart review that focuses on the role of drugs as both therapeutic and iatrogenic agents in the sum of health care given to a patient is presented. A team of 11 to 16 health care professionals evaluated ambulatory health care systems funded by HEW. All clinician evaluators participated in the medical audit segment of the evaluation. Drug therapy review was based on an assessment of the relationship between patient, drug and other factors. Discussed also are the nine assessment options open to the evaluator and the mechanisms used to incorporate findings into the larger system review process. A by-product of the use of this process was increased prescribed-pharmacist cooperation and contribution in performance of the medical audit.