Drug Use Evaluation

DUE
Systemic process used to assess the
appropriateness of drug therapy by
engaging in the evaluation of data on
drug use in given health care
environment against predetermined
criteria or standards.
First established in 1980s

 Outcome assessment
Provide ongoing structured, organized
approach to ensure that drugs are used
appropriately.

Desired endpoint
Safe, efficacious drug therapy

 MUE
Encompasses the goals and objectives
of DUE in its broadest application, with
an emphasis on improving patient
outcomes
Need for a more multifaceted approach
to improving medication use
Incorporated into the overall hospital
performance improvement process

 There are multiple performance

improvement model. The most
common model is FOCUS-PDCA
Find process to improve
Organize a team that knows the
process
Clarify current knowledge of the
process
Understand causes of process
variation

 There are multiple performance

improvement model. The most
common model is FOCUS-PDCA
Plan
Do
Check
Act

 Pharmacist can take a leadership role

in designing the DUE programs
Programs should measure and compare
the outcomes of patients who received
the drug therapy in concert with
approved criteria versus those who did
not.

Medication Use Criteria

Diagnosis-related DUE
Identify indications for which select drugs
may be appropriate for a given disease state.

Prescriber-related DUE
identify specific physicians whom the P&T
committee has determined may use certain
drugs

Drug-specific DUE
Focus on specific aspects of a select drug
such as the dose or dosing frequency

 Criteria should be focused and limited

Data should be collected during the
patient visit (concurrent) rather than
retrospectively (chart review)
Concurrent review
More complete
Allows pharmacist to obtain information
from the prescriber that may not have been
clear in the medical record
Timely information

 Collection
Technology may be used to collect or
screen data. Hand-held computers or
personal data assistants (PDAs) are
useful in data collection process.

Compiled for review

Use of trend graphs or control charts are
helpful in identifying opportunities for
improvement

 Evaluation of the results

Validation
Drug use is appropriate and safe

Opportunity for improving the way a

drug is used

Action plan
Task force
Key physicians, nurses, pharmacist, and
other health care professional appropriate
to the drug therapy under review.

 Action plan
Development of drug use guidelines
Preprinted orders
Medication order entry rules
Professional staff education
Formulary changes
Combination of these actions

Presented to the P&T committee for

consideration