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DUR: About The DUR Program

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Drug Use Review (DUR) was a term used in the early days of clinical pharmacy to represent any effort to review a patient's drug therapy in order to improve care. DUR became significant for Medicaid recipients and providers when Congress passed the Federal Omnibus Budget Reconciliation Act (OBRA) of 1990 (Section 4401), requiring each state to establish a DUR program for covered outpatient drugs. The program objective is to educate physicians and pharmacists on ways to improve the quality of patient care by increasing awareness of therapeutic issues.

California's Medi-Cal DUR is a dynamic program designed to optimize recipients' medical and pharmaceutical care, and to reduce the costs of this care. It is the clinical portion of Medi-Cal interested only in the proper use of drugs in the practice of medicine and pharmacy. DUR reviews outpatient prescribing patterns, alerts pharmacists to potential prescribing hazards and educates all providers, enabling them to render the best possible care to recipients.

Central to the DUR program is the DUR Board, comprised of volunteer pharmacists and physicians with active practices in California. The DUR Board acts in an advisory role to the State on drug use considerations, develops criteria to evaluate drug therapy, regularly reviews resulting evaluations, and recommends educational interventions and further criteria.

Ongoing dialogue among DUR Board members and DUR staff guides day-to-day work. The foundation of this working dialogue is the daily data processing performed by the Conduent/DUR pharmacist and support staff. DUR uses a broad array of tools that allow real-time evaluation of recipient medical and pharmaceutical care. In fact, Medi-Cal has one of the most data-integrated systems in the nation to view many different data elements in every conceivable relationship. This ability to quickly relate data, such as diagnosis with certain alert codes, enables DUR to explore and assess trends in medical care and recommend ways to support or modify these trends.

Today's rapidly changing landscape of medical care challenges providers to remain current with new information and technologies and, at the same time, provide the best possible care to recipients. The Medi-Cal DUR program is an active participant in meeting this challenge. By using the best tools, maintaining a high quality staff, and building and customizing a powerful decision-making process, DUR works to support the provider with an interactive information environment and provide recipients with an optimal care environment.