New Alert Override Codes for the Drug Utilization Review System Derived from Outpatient Prescription Data from a Tertiary Teaching Hospital in Korea

김우재; 안은경; 유기봉; 박래웅; 장철; 박만영

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자료유형: 학술저널

저자정보: 김우재 안은경 유기봉 박래웅 장철 박만영

저널정보: 대한의료정보학회 Healthcare Informatics Research Healthcare Informatics Research 제22권 제1호

발행연도: 2016.1

수록면: 39 - 45 (7page)

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Objectives: This paper proposes new alert override reason codes that are improvements on existing Drug Utilization Review (DUR) codes based on an analysis of DUR alert override cases in a tertiary medical institution. Methods: Data were obtained from a tertiary teaching hospital covering the period from April 1, 2012 to January 15, 2013. We analyzed cases in which doctors had used the 11 overlapping prescription codes provided by the Health Insurance Review and Assessment Service (HIRA) or had provided free-text reasons. Results: We identified 27,955 alert override cases. Among these, 7,772 (27.8%) utilized the HIRA codes, and 20,183 (72.2%) utilized free-text reasons. According to the free-text content analysis, 8,646 cases (42.8%) could be classified using the 11 HIRA codes, and 11,537 (57.2%) could not. In the unclassifiable cases, we identified the need for codes for “prescription relating to operation” and “emergency situations.” Two overlapping prescription codes required removal because they were not used. Codes A, C, F, H, I, and J (for drug non-administration cases) explained surrounding situations in too much detail, making differentiation between them difficult. These 6 codes were merged into code J4: “patient was not taking/will not take the medications involved in the DDI.” Of the 11 HIRA codes, 6 were merged into a single code, 2 were removed, and 2 were added, yielding 6 alert override codes. We could codify 23,550 (84.2%) alert override cases using these codes. Conclusions: These new codes will facilitate the use of the drug–drug interactions alert override in the current DUR system. For further study, an appropriate evaluation should be conducted with prescribing clinicians.

#Drug Utilization Review #Drug Interactions #Outpatient Care #Clinical Decision Support Systems #Contraindications

참고문헌 (14)

참고문헌 신청

최남경 / 2010 / 한국형 DUR의 효과적 추진전략 / 대한의사협회지 53(12):1130~1138

최종수 / 2013 / 동시적 의약품 사용평가(cDUR) 시스템 구축 및 적용 사례 연구 : 국내 한 대학병원을 중심으로 / 대한산업공학회지 39(1):20~29

Strom BL / 2012 / Pharmacoepidemiology / Wiley-Blackwell

전하림 / 2014 / 의약품 사용평가(DUR) 사업의 미국 47개주 Medicaid 자료비교 및 정책적 함의 고찰 / 보건사회연구 34(3):192~221

김동숙 / 2014 / 의약품 처방·조제지원서비스(Drug Utilization Review)사업이 병용금기 처방률에 미치는 영향 / 보건행정학회지 24(2):120~127

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