의약품 치료군 중복에 대한 DUR 기준개발 연구

Background Drug utilization review (DUR) is to ensure safe drug use and optimal therapeutic outcomes. Therapeutic duplication is one of the most frequently reported inappropriate drug use categories in Korea. Specific criteria of drug ingredients considered duplicate would be helpful to prevent therapeutic duplications during drug prescribing and dispensing. Objectives This study was aimed to develop therapeutic duplication criteria of 4 drug classes including lipid modifying agents, antihypertensives, antibiotics and drugs for acid-related disease and estimate the prevalence of therapeutic duplications in ambulatory setting in Korea. Method To develop therapeutic duplication criteria, WHO Anatomical, Therapeutical and Chemical (ATC) classification system was used. Any clinically accepted therapeutic duplications were excluded from this criteria after checking clinical practice guidelines and textbooks. This therapeutic duplication criteria was modified and confirmed via an expert consensus panel using a 2-phase Delphi method. The prevalence of therapeutic duplication of drugs for acid related disorder, anti-hypertensives, lipid modifying drugs, and antibacterials was examined using health insurance claims data including 40 million patients during the 12-month period form January through December 2009. Result 5.87% from prescribed medications for acid-related disease were identified as therapeutic duplication. Also, 1.5% from prescribed medication for anti-hypertensive drugs, 0.12% for anti-lipidemia drugs and 2.75% for antibacterials were identified as therapeutic duplication. Conclusion These results are expected to be helpful to prevent therapeutic duplication and improve appropriate medication use.