Need for a national drug utilization review (DUR) criteria knowledgebase

Under Health Care Reform proposals have been made for a national advisory panel. We propose the development of a knowledge base with appropriate and specific screening criteria in the form of knowledge rules. Initial credible information for the knowledge base could be derived from authoritative drug compendia. Provisions should exist for knowledge rules to be adjusted in order to accommodate state differences. Once developed, the national advisory panel could oversee the process of DUR knowledge rules development, validation and maintenance. The panel could also provide a more efficient centralized and vigorous supervision, while it ensured a reliable and valid measurement of drug use. We believe that standardization would enhance appropriately the further development and evaluation of computerized DUR systems. Since computer knowledge bases have vast memory capacity and rapid data retrieval, continuous reinforcement of important drug information is possible. Information can be presented to warn physicians and pharmacists of drug therapy problems according to severity and probability and to encourage choice among alternative therapies. These data are not available today in most drug claims files