Computerized drug-use evaluation

A drug-use evaluation (DUE) of angiotensin-converting-enzyme (ACE) inhibitors by both manual and computerized methods was conducted. Criteria for the use of ACE inhibitors were developed and approved. Fifty patients were randomly selected from 225 clinic outpatients who had begun taking an ACE inhibitor during a six-month period. The clinic medical records of each of the patients were reviewed by a pharmacist to determine compliance with the DUE criteria. At the same time, a computer program queried the computerized medical records of the same patients to evaluate adherence to the criteria. The manual method showed that ACE inhibitor therapy met threshold for two of the six criteria before exceptions were considered and for three criteria after exceptions were considered. Results for only two criteria met threshold when evaluated by the computer; the computer did not consider exceptions. There was good or excellent percent agreement between the manual and computerized methods for four of the six criteria. Kappa values showed that the agreement for five criteria was significant. A computerized method of evaluating drug use performed similarly to manual evaluation, but agreement was best for simply stated criteria.