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Norah Al Johany
Head of Pharmacoeconomic department
General administration of pharmaceutical care
noaljohany@moh.gov.sa
Dr...
Estimate cost of drug-related
morbidity and mortality
Clinical Pharmacists Affect Mortality
Seven services associated with reduced mortality rate:
1. Drug Use evaluation
2. Pat...
Definition
DUE is a performance improvement method that focuses on
evaluating and improving medication –use processes with...
Medication Use Evaluation (MUE), or
Drug Use Evaluation (DUE)
Patient
outcomes
Evaluating
medication
use
Systematic
ally
M...
Medication Use
Evaluation (MUE)
Drug Use Evaluation
(DUE)OR
Patient out
comes &
Individual
Patient quality
of life
Inventory
management
Prescribing
Preparing
Dispensing
Administration
Monitoring
Patient out
comes
Formulary
management
Ide...
MUE Objectives
• Promoting optimal medication therapy.
• Preventing medication-related problems.
• Evaluating the effectiv...
MUE Objectives
• Enhancing opportunities, through standardization, to assess the
value of innovative medication-use practi...
• Minimizing costs of medication therapy. These costs may be only
partly related to the direct cost of medications themsel...
Types Of MUE
• Specific medication (e.g. alteplase)
• Class of medication (e.g., thrombolytics)
• Medications used in the ...
Types Of MUE
• Medications related to clinical event (e.g., drug therapy with in the
first 24 hours for patients admitted ...
Steps of the MUE Process
• Establish organizational authority for the MUE process and identify
responsible individuals and...
Steps of the MUE Process
• Educate health care professionals to promote the use of criteria,
guidelines, treatment protoco...
• Assess the effectiveness of actions taken, and document
improvements
• Incorporate improvements into criteria, guideline...
Indicators Suggesting a Need for
MUE Analysis
• Preventable adverse drug reactions, and toxicity
• Medication errors
• The...
Roles and Responsibilities
in the MUE Process
• Quality management committee
• Pharmacy and therapeutics committee
should ...
Pharmacist’s Responsibilities in
MUE
• Plan
• Management
• goals
• Collaboration
• Education
• Reviewing individual medica...
Resources
• The primary
• Published criteria, such as found in AJHP and ASHP’s Criteria for
Drug Use Evaluation (volumes 1...
Criteria
• Are statements of the activity to be measured
• Should be based on the best practice
• Appropriate for the targ...
The Report
• Should contain the rationale for the topic selection
• Team members involved in the evaluation
• Description ...
Follow up
• The same criteria, standards, and sample should be used for the
follow up assessment as in the initial assessm...
Pitfalls
• Lack of authority
• Lack of organization
• Poor communication
• Poor documentation
• Lack of involvement
• Lack...
Pitfalls
• Lack of authority.
• Lack of organization.
• Poor communication.
• Poor documentation.
• Lack of involvement.
•...
(DUE) Drug use evaluation
(DUE) Drug use evaluation
(DUE) Drug use evaluation
(DUE) Drug use evaluation
(DUE) Drug use evaluation
(DUE) Drug use evaluation
(DUE) Drug use evaluation
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(DUE) Drug use evaluation

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(DUE) Drug use evaluation

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(DUE) Drug use evaluation

  1. 1. Norah Al Johany Head of Pharmacoeconomic department General administration of pharmaceutical care noaljohany@moh.gov.sa Drug Use Evaluation (DUE) “Utilization”
  2. 2. Estimate cost of drug-related morbidity and mortality
  3. 3. Clinical Pharmacists Affect Mortality Seven services associated with reduced mortality rate: 1. Drug Use evaluation 2. Patient Education 3. ADR Management 4. Pharmacy Protocol Management 5. Code Team Participation 6. Admission Drug Histories 7. Participation on Rounds Pharmacotherapy 2007;27(4):481-493
  4. 4. Definition DUE is a performance improvement method that focuses on evaluating and improving medication –use processes with the goal of optimal patient outcomes Am J Hosp Pharm. 1996;53:1953-5
  5. 5. Medication Use Evaluation (MUE), or Drug Use Evaluation (DUE) Patient outcomes Evaluating medication use Systematic ally Monitoring Program
  6. 6. Medication Use Evaluation (MUE) Drug Use Evaluation (DUE)OR Patient out comes & Individual Patient quality of life
  7. 7. Inventory management Prescribing Preparing Dispensing Administration Monitoring Patient out comes Formulary management Identify Resolve Prevent medication related problems (MUE) process helps to
  8. 8. MUE Objectives • Promoting optimal medication therapy. • Preventing medication-related problems. • Evaluating the effectiveness of medication therapy. • Improving patient safety. • Stimulating improvements in medication-use processes. • Stimulating standardization in medication-use processes
  9. 9. MUE Objectives • Enhancing opportunities, through standardization, to assess the value of innovative medication-use practices from both patient- outcome and resource-utilization perspectives. • Minimizing procedural variations that contribute to suboptimal outcomes of medication use • Identifying areas in which further information and education for health care professionals may be needed.
  10. 10. • Minimizing costs of medication therapy. These costs may be only partly related to the direct cost of medications themselves. When medications are selected and managed optimally from the outset, the costs of complications and wasted resources are minimized, and overall costs are decreased • Meeting or exceeding internal and external quality standards (e.g., professional practice standards, accreditation standards, or government laws and regulations) MUE Objectives
  11. 11. Types Of MUE • Specific medication (e.g. alteplase) • Class of medication (e.g., thrombolytics) • Medications used in the management of a specific disease state or clinical setting (e.g. thrombolytics in acute myocardial infarction)
  12. 12. Types Of MUE • Medications related to clinical event (e.g., drug therapy with in the first 24 hours for patients admitted with acute MI) • Specific component of the medication use process (e,g time from admission to administration of thrombolytics • Based on a specific outcome (vessel patency following thrombolytic administration)
  13. 13. Steps of the MUE Process • Establish organizational authority for the MUE process and identify responsible individuals and groups. • Develop screening mechanisms (indicators) for comprehensive surveillance of the medication-use system. • Set priorities for in-depth analysis of important aspects of medication use. • Inform health care professionals (and others as necessary) in the practice setting(s) about the objectives and expected benefits of the MUE process. • Establish criteria, guidelines, treatment protocols, and standards of care for specific medications and medication-use processes. These should be based on sound scientific evidence from the medical and pharmaceutical literature
  14. 14. Steps of the MUE Process • Educate health care professionals to promote the use of criteria, guidelines, treatment protocols, and standards of care. • Establish mechanisms for timely communication among health care professionals. • Initiate the use of MUE criteria, guidelines, treatment protocols, and standards of care in the medication-use process. • Collect data and evaluate care. • Develop and implement plans for improvement of the medication- use process based on MUE findings (if indicated)
  15. 15. • Assess the effectiveness of actions taken, and document improvements • Incorporate improvements into criteria, guidelines, treatment protocols, and standards of care, when indicated. • Repeat the cycle of planning, evaluating, and taking action for ongoing improvement in medication-use processes. • Regularly assess the effectiveness of the MUE process itself and make needed improvements. Steps of the MUE Process
  16. 16. Indicators Suggesting a Need for MUE Analysis • Preventable adverse drug reactions, and toxicity • Medication errors • The medication is most effective when used in a specific way. • Signs of treatment failures • Pharmacist interventions to improve medication therapy • Formulary management • Patient dissatisfaction or deterioration in quality of life. • Expensive medication • frequently prescribed.
  17. 17. Roles and Responsibilities in the MUE Process • Quality management committee • Pharmacy and therapeutics committee should have, at a minimum, prescriber, pharmacist, nurse, and administrator representation. • Temporary working groups may be used for.
  18. 18. Pharmacist’s Responsibilities in MUE • Plan • Management • goals • Collaboration • Education • Reviewing individual medication orders • Data collection • Reporting
  19. 19. Resources • The primary • Published criteria, such as found in AJHP and ASHP’s Criteria for Drug Use Evaluation (volumes 1–4), provide. • Computer software programs • External standards-setting bodies, such as the Joint Commission on Accreditation of Healthcare Organizations,
  20. 20. Criteria • Are statements of the activity to be measured • Should be based on the best practice • Appropriate for the target patient population • Supported by current literature • Multidisciplinary group develops the criteria • Should be phrased yes/no or T/F • Should avoid interpretation on the part of data collection • Assess important aspects in the use of the medication evaluated • Focus on aspects related to outcomes.
  21. 21. The Report • Should contain the rationale for the topic selection • Team members involved in the evaluation • Description of the patient population evaluated • Any selection criteria used • A copy of the criteria /indicators • Discussion of the results • Identification of likely causes for opportunities identified • Recommendations for corrective action • Follow –up evaluation
  22. 22. Follow up • The same criteria, standards, and sample should be used for the follow up assessment as in the initial assessment
  23. 23. Pitfalls • Lack of authority • Lack of organization • Poor communication • Poor documentation • Lack of involvement • Lack of follow-through • Lack of readily retrievable data and information management
  24. 24. Pitfalls • Lack of authority. • Lack of organization. • Poor communication. • Poor documentation. • Lack of involvement. • Lack of follow-through • Evaluation methodology that impedes patient care • Lack of readily retrievable data and information

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