DRUG UTILIZATION REVIEW PROGRAM IN SAUDI HOSPITALS: ENABLING FACTORS AND IMPELMENTATION

Abstract

Objectives: Adoption of Drug Utilization Review (DUR) program is essential to optimize the safety and effectiveness of medication use in health care sitting. The aim of the study is to explore the enabling factors to adopt DUR program and to explore DUR program implementation in Saudi Hospitals. Methods: A cross-sectional survey targeted mangers at hospital pharmacy with in-patient and out-patient pharmacies in Riyadh City in 2014. The survey gathered information about the hospital pharmacy services, pharmacy information system (PIS), Pharmacy & Therapeutics (P&T) Committee activities. Results: Of the 30 hospital pharmacies, 23 (76.6%) pharmacy managers responded, and only 21(70%) hospital pharmacies met the inclusion criteria. 18(85.7% ) hospitals have Electronic Medical Record (EMR) and 14(66.67%) of them have Computerized Physician Order Entry (CPOE). 12 (57.2 %) of the hospitals have Pharmacy and laboratory integrated information systems, 6 (28.6%) hospitals have Clinical Decision-Support Systems (CDSSs), 7(33.3%) hospital pharmacies provide Patient Discharge Counseling Services (PDCS), 13 (61.9%) provide Inpatient Clinical Pharmacy Services(ICPS), 14 (66.7%) provide Therapeutic Drug Monitoring (TDM) services. 8 (38.1%) hospitals have PIS which can detect incorrect dose and duration, 8 (38.1%) for drug-drug interaction, 6(28.6%) for drug-disease Interaction, 7 (33.3%) for contraindication and 11 (52.3%) for early refill detection. Only 6 (28.6%) hospitals PISs have the capability to generate four types of retrospective reports (ranking physicians by utilization, drug they prescribe, most utilized drug by number of patients, most utilized drug by diagnosis. 18 (85.7%) hospitals ' P&T Committee discuss the DUR reports at least once annually. 10 (45.2%) of the hospitals have designated subcommittees for DUR. Conclusions: The enabling factors for the prospective and concurrent DUR such as CDSSs, PDCS, ICPS, and PIS detection capabilities are not adopted widely as standard process or services in Saudi hospitals, likewise the retrospective DUR. The DUR programs at these hospitals have huge opportunity to improve.