Drug Utilization Review Systems in Modern Pharmacy
Understand prospective, concurrent, and retrospective DUR systems, how they catch medication errors, and the pharmacy technician role in DUR processes.
What Is Drug Utilization Review?
Drug utilization review (DUR) is a systematic process for evaluating prescription drug use to ensure medications are used appropriately, safely, and effectively. DUR systems are built into pharmacy software and insurance claims processing. This topic appears frequently on the PTCB exam.
Three Types of DUR
Prospective DUR
This review happens before dispensing. The software screens for drug-drug interactions, duplicate therapy, incorrect dosing, drug-allergy conflicts, and therapeutic duplication. Alerts appear for pharmacist review.
Concurrent DUR
This occurs during therapy in hospital and long-term care settings. Clinical pharmacists monitor lab values, serum drug levels, and outcomes. Technicians support by pulling lab reports and flagging patients on high-alert medications.
Retrospective DUR
This analyzes prescribing patterns after dispensing. Insurance companies use it to identify unusual patterns, excessive quantities, and improvement opportunities.
Common DUR Alerts
- Drug-drug interaction: Such as warfarin and fluconazole
- Therapeutic duplication: Two drugs from the same class
- Drug-disease contraindication: Inappropriate for patient condition
- Excessive duration: Beyond guideline recommendations
- Incorrect dose: Outside normal range for age, weight, or renal function
Technician Role
Technicians are the first to see DUR alerts on screen. Ensure alerts are not ignored without pharmacist review. Document overrides properly and understand that alert fatigue is a real patient safety concern.
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