Drug Utilization Review Explained for PTCB Prep

What Is Drug Utilization Review?

Drug utilization review (DUR) is a systematic process of evaluating prescription drug use to ensure medications are used appropriately, safely, and effectively. DUR is a core concept on the PTCB certification exam and a critical component of pharmacy practice that pharmacy technicians support daily.

Types of Drug Utilization Review

DUR is categorized into three types based on when the review occurs:

Prospective DUR

Prospective DUR occurs before the medication is dispensed to the patient. This is the most common form of DUR in community pharmacy and happens every time a prescription is processed. The pharmacy system automatically checks for:

Drug-drug interactions
Drug-allergy interactions
Duplicate therapy
Incorrect dosage (too high or too low)
Drug-disease contraindications
Inappropriate duration of therapy
Drug-age precautions (pediatric or geriatric concerns)
Drug-gender precautions (pregnancy considerations)

When the system flags a potential issue, an alert is generated. The pharmacist must evaluate the alert and decide whether to proceed, contact the prescriber, or take other action.

Concurrent DUR

Concurrent DUR occurs during the course of treatment. This type of review is more common in hospital and long-term care settings, where ongoing medication use is monitored in real time. Examples include:

Monitoring IV medication administration rates
Tracking antibiotic therapy duration to prevent resistance
Assessing therapeutic drug monitoring (TDM) results to adjust doses
Reviewing medication orders during patient rounds

Retrospective DUR

Retrospective DUR occurs after the medication has been dispensed. It uses claims data and patient records to identify patterns of inappropriate prescribing or use. Examples include:

Identifying patients receiving high-risk medications (such as the Beers Criteria drugs in the elderly)
Analyzing prescribing patterns for controlled substances
Detecting polypharmacy issues across multiple prescribers
Evaluating adherence rates for chronic disease medications

The Pharmacy Technician's Role in DUR

While the clinical evaluation of DUR alerts is the pharmacist's responsibility, pharmacy technicians support the DUR process by:

Ensuring accurate patient profiles (allergies, medications, conditions) to make DUR effective
Recognizing when a DUR alert appears during prescription processing and flagging it for the pharmacist
Never overriding DUR alerts without pharmacist authorization
Updating patient allergy and medication information when changes are reported

PTCB Exam Tips

For the PTCB exam, know the three types of DUR, understand that prospective DUR is the most commonly tested type, and remember that only a pharmacist can make clinical decisions about DUR alerts. Pharmacy technicians support DUR but do not perform clinical evaluations.

Practice DUR questions and more at PTCBprep mini exams and build your study plan at PTCBprep.