Pharmacists' reactions to the Wisconsin Medicaid drug-use review program

Pharmacists' reactions to inquiries on Medicaid drug-use review (DUR) and how the information supplied by such inquiries influenced pharmacists' interactions with physicians were studied. A questionnaire was mailed in September 1991 to all 137 pharmacies that had been contacted in 1989 by the Wisconsin Medicaid DUR program about potentially inappropriate use of histamine H2-receptor antagonists. The survey sought to determine whether pharmacists used information in the DUR letters and, if so, how. A section for consultants was included to identify possible differences in responses between consultant and nonconsultant pharmacists. A response was received from 96 of the 137 pharmacies contacted. Pharmacists reported that the issues raised by the DUR letter frequently were discussed with the prescriber. Most respondents attempted to make changes in drug therapy based on the information supplied in the DUR letter. Consultant pharmacists were less likely than nonconsultants to refer to the DUR letter but were more likely to consider inclusion of copies of references to the medical literature helpful, to contact the prescriber in writing, to discuss alternative therapies or discontinuation of therapy, and to suggest patient-monitoring activities. Although consultants and nonconsultants tend to use DUR information in different ways, DUR does offer helpful information that is used by Wisconsin pharmacists in making drug therapy recommendations to prescribers.