Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.
In Reply: Dr Berringer and colleagues identify
a number of perceived weaknesses of the retrospective drug utilization review
programs that we studied (eg, failure to use diagnosis data to identify diseases,
and overly simplified criteria), and wonder whether improvements might make
retrospective drug utilization review programs effective. In fact, the software
used by the programs that we studied did use diagnosis data to identify drug-disease
interactions, and those deciding which exceptions should result in alerts
did have access to patient-specific factors such as those mentioned by Berringer
et al. We agree that the low alert rate that we found could well explain a
lack of effect, as we stated in our article, but this reflects how such programs
were implemented. Furthermore, we did not find a dose-response relationship
with numbers of alerts.
Hennessy S, Bilker WB, Weber AL, Brensinger C, Strom BL. Evaluation of Drug Utilization Review Programs—Reply. JAMA. 2004;291(2):184-185. doi:10.1001/jama.291.2.185-b