Analysis of Prescriptions Not Recommended for Concomitant Use
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In accordance with the drug utilization review program developed in 2004, a single general hospital of 2,400 beds instituted prescription control of the drug combinations to avoid (DCA) in 2006. However, in order to treat certain patients, it is necessary to use some of these drugs together. Therefore, this study was conducted for the purpose of guiding safe drug use by analyzing prescriptions, monitoring rates, and the incidence of personal injury for DCA selectively allowed by the hospital’s Committee of‘ Medication Management and Use’. This study was conducted on patients administered DCA during a hospitalization period from August 1, 2016, to July 31, 2017, in a single general hospital in Korea. Prescription status, monitoring status, and the occurrence of drug interactions were reviewed in the medical records retrospectively. As a result, among the DCA designated by the MFDS (Korea Ministry of Food and Drug Safety), 306 cases of 17 combinations were used during the one-year study period. Of the total prescriptions, followup monitoring occurred in 110 cases (35.9%) and there were 42 (13.7%) adverse drug events (ADE). However, since 176 cases (57.5%) were not monitored, ADEs were not identified in those patients. In addition, the DCA prescription rate for children and the elderly, who have a high probability for ADEs, was 38.2% (117 cases) and 12.1% (37 cases), respectively, and accounted for 50.3% of all cases. Prescribing DCA is highly likely to cause harm to patients. Although it should be accompanied by follow- up monitoring, a low monitoring rate was observed in this study. Therefore, additional measures are needed, such as follow-up by the pharmacist. In particular, it is necessary to concentrate on children and the elderly. This study has significance, not only in its analysis of DCA prescriptions but also for post-management, which offers a basis for safer drug use.
Abstract
In accordance with the drug utilization review program developed in 2004, a single general hospital of 2,400 beds instituted prescription control of the drug combinations to avoid (DCA) in 2006. However, in order to treat certain patients, it is necessary to use some of these drugs together. Therefore, this study was conducted for the purpose of guiding safe drug use by analyzing prescriptions, monitoring rates, and the incidence of personal injury for DCA selectively allowed by the hospital’s Committee of‘ Medication Management and Use’. This study was conducted on patients administered DCA during a hospitalization period from August 1, 2016, to July 31, 2017, in a single general hospital in Korea. Prescription status, monitoring status, and the occurrence of drug interactions were reviewed in the medical records retrospectively. As a result, among the DCA designated by the MFDS (Korea Ministry of Food and Drug Safety), 306 cases of 17 combinations were used during the one-year study period. Of the total prescriptions, followup monitoring occurred in 110 cases (35.9%) and there were 42 (13.7%) adverse drug events (ADE). However, since 176 cases (57.5%) were not monitored, ADEs were not identified in those patients. In addition, the DCA prescription rate for children and the elderly, who have a high probability for ADEs, was 38.2% (117 cases) and 12.1% (37 cases), respectively, and accounted for 50.3% of all cases. Prescribing DCA is highly likely to cause harm to patients. Although it should be accompanied by follow- up monitoring, a low monitoring rate was observed in this study. Therefore, additional measures are needed, such as follow-up by the pharmacist. In particular, it is necessary to concentrate on children and the elderly. This study has significance, not only in its analysis of DCA prescriptions but also for post-management, which offers a basis for safer drug use.
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