OBJECTIVES: Therapeutic duplication (TD) information is one of the drug utilization review (DUR) system provided by Health Insurance Review and Assessment Service (HIRA). TD provides information about duplicated agents in same therapeutic group used together in one patient over the same period. It cannot expect any additional medical effect and the risk of adverse effects could be increased. We figure out the changes in TD prescribing pattern through DUR in VHS medical center.

METHODS: We used electronic medical record(EMR) database from March to August 2020 and 2021. Study subjects were the veterans who were prescribed at the outpatient pharmacy in the hospital. Study drugs were selected 20 analgesic drugs, 8 dyslipidemia drugs, 39 anti-hypertension drugs, 4 sedative hypnotic drugs, 4 opioid drugs, 39 psychiatric drugs, 26 respiratory drugs of TD information by referring reimbursement drugs list of HIRA. We calculated frequency of TD prescription by variable such as specialty and efficacy. By utilizing evaluation indexes, we checked change patterns during study period and conducted paired t-test.

RESULTS: The TD rate in 2020 is 0.92% and the TD rate in 2021 is 1.05%. The absolute rate of change is 0.12, indicating that the TD rate in 2021 increased compared to 2020. But the p-value was 0.25, which was not statistically significant. The specialties with decrease in TD rate in 2021 were neuropsychiatry, hemato-oncology, cardiothoracic surgery, otolaryngology, endocrinology, gastroenterology, urology, neurology, dental clinic. However, the p-value was greater than 0.05. Also, the efficacy group with the decrease in TD rate in 2021 was sedative hypnotic drugs and psychiatric drugs. Among them, the p-value of the psychiatric drugs was 0.01 and it decreased statistically significantly.

CONCLUSIONS: To enhance the influence of TD information effectively, it is necessary to strengthen prescription monitoring for frequent TD drugs and to simplify the conditions for providing alert on DUR system.