Prospective Drug Utilization Review

(1) A pharmacist shall conduct a prospective drug utilization review ("DUR") before each new prescription or medication order is dispensed or delivered to a patient or a patient's agent. The DUR may include a review of computerized alerts, the patient record, and each new and renewed prescription or medication order for the purpose of promoting therapeutic appropriateness, by making a reasonable effort to identify the following: (a) over-utilization or under-utilization; (b) therapeutic duplication; (c) drug-disease contraindication; (d) drug-drug interaction; (e) drug-food interaction; (f) incorrect drug dosage or duration of drug treatment; (g) drug-allergy interactions; (h) abuse or misuse; (i) any significant change in drug, dose, or directions; and (j) any age related contraindications. (2) Upon identifying any of the above, a pharmacist shall take appropriate measures to ensure the proper care of the patient which may include consultation with the prescribing practitioner or direct consultation with the patient or patient's agent. A pharmacist shall document any measures taken in response to a drug utilization review. (3) The DUR shall be based upon current standards which may include the following: (a) the American Hospital Formulary Service Drug Information; (b) the United States Pharmacopoeia Drug Information; (c) the American Medical Association Drug Evaluations; (d) Plumb's Veterinary Drug Handbook; and (e) other peer-reviewed medical literature.