Unit 18: Drug Utilization Reviews

A pharmacist reviews a patient’s medication history and identifies a previous dosing error, then corrects it moving forward. What process is being performed?
A. Medication reconciliation
B. Drug utilization review (DUR)
C. Adverse event reporting
D. Therapeutic substitution

B. Drug utilization review (DUR)

A pharmacy technician notices a patient is refilling opioid prescriptions too early and alerts the pharmacist. What is the technician’s correct role?
A. Perform a DUR independently
B. Ignore since DUR is pharmacist-only
C. Flag suspicious activity for pharmacist review
D. Deny the prescription

C. Flag suspicious activity for pharmacist review

A pharmacist explains to a patient how to properly take their medication to improve compliance. This requirement was mandated under which law?
A. HIPAA
B. Controlled Substances Act
C. OBRA 1990
D. FDCA

C. OBRA 1990

A patient consistently follows medication instructions exactly as prescribed. What term describes this behavior?
A. Compliance
B. Persistence
C. Adherence
D. Concordance

C
(WHO definition: degree patient follows healthcare recommendations

A state requires pharmacists to review patient medication profiles and counsel patients before dispensing. What is the primary purpose?
A. Increase pharmacy profits
B. Improve patient safety and adherence
C. Reduce insurance claims
D. Eliminate generic drugs

B. Improve patient safety and adherence

A pharmacy skips patient counseling to save time. Which law is being violated?
A. OSHA
B. OBRA 1990
C. DEA Act
D. FDAAA

B. OBRA 1990

A DUR identifies a prescribing error and ensures it does not happen again for other patients. What is this an example of?
A. Individual-only benefit
B. Population-level safety improvement
C. Insurance auditing
D. Drug recall

B. Population-level safety improvement

A pharmacist begins a DUR by defining the intended treatment outcome before reviewing data. What step is this?
A. Monitoring
B. Target therapeutic goal
C. Data collection
D. Follow-up

B. Target therapeutic goal

A DUR protocol includes identifying what data is needed and how to analyze it. What is this describing?
A. Clinical trial
B. Protocol formation
C. Drug recall system
D. DEA compliance

B. Protocol formation

After a DUR identifies repeated dosing errors, the pharmacy implements a new safety policy. What is this step?
A. Diagnosis
B. Recommendation and follow-up
C. Initial screening
D. Drug selection

B. Recommendation and follow-up

A pharmacist checks for drug interactions BEFORE dispensing a prescription. What type of DUR is this?
A. Retrospective
B. Concurrent
C. Prospective
D. Preventive audit

C. Prospective

A pharmacist identifies a dosing error DURING the filling process and stops the prescription. What type of DUR is this?
A. Prospective
B. Concurrent
C. Retrospective
D. Investigational

B. Concurrent

A pharmacy reviews patient outcomes months after therapy to identify harmful trends. What type of DUR is this?
A. Prospective
B. Concurrent
C. Retrospective
D. Predictive

C. Retrospective

Which DUR type has the greatest risk of harm already occurring before detection?
A. Prospective
B. Concurrent
C. Retrospective
D. Preventive

C. Retrospective

Which DUR type is BEST at preventing errors before they occur?
A. Retrospective
B. Concurrent
C. Prospective
D. Post-market

C. Prospective

A pharmacist lacks full patient medication history during review, increasing risk of missed interactions. Which DUR type limitation is this?
A. Prospective
B. Concurrent
C. Retrospective
D. Experimental

B. Concurrent

A pharmacist ensures a medication is appropriate for a patient’s condition with no contraindications. What factor is being assessed?
A. Dosing
B. Indications
C. Monitoring
D. Administration

B. Indications

A pharmacist checks if a prescribed drug is the best choice for a condition. What DUR factor is this?
A. Drug selection
B. Indication
C. Monitoring
D. Results

A. Drug selection

A pharmacist evaluates whether a patient is receiving too high or too low of a dose. What is being assessed?
A. Administration
B. Dosing
C. Monitoring
D. Preparation

B. Dosing

A pharmacist checks for interactions between two medications and certain foods. What category does this fall under?
A. Indications
B. Monitoring
C. Interactions
D. Results

C. Interactions

A pharmacist ensures the correct compounding steps were followed for a medication. What factor is being reviewed?
A. Administration
B. Preparation
C. Monitoring
D. Selection

B. Preparation

A pharmacist verifies how a medication should be taken and how much is dispensed. What factor is this?
A. Administration
B. Monitoring
C. Results
D. Indications

A. Administration

A pharmacist educates a patient on how to take a medication safely. What DUR factor is this?
A. Monitoring
B. Counseling
C. Results
D. Preparation

B. Counseling

A pharmacist tracks patient lab values over time while on therapy. What DUR factor is this?
A. Results
B. Monitoring
C. Indications
D. Selection

B. Monitoring

A pharmacist evaluates whether a drug achieved its intended effect. What DUR factor is this?
A. Monitoring
B. Results
C. Administration
D. Preparation

B. Results

A patient receives a medication that interacts with another drug they were already taking. This error could BEST have been prevented by which DUR type?
A. Retrospective
B. Concurrent
C. Prospective
D. Post-analysis

C. Prospective

A pharmacist identifies a pattern of overdosing in multiple patients months after prescriptions were filled. What type of DUR detected this?
A. Prospective
B. Concurrent
C. Retrospective
D. Immediate

C. Retrospective

A DUR is being conducted but lacks complete patient medication history, leading to repeated reviews. What is the main issue?
A. Poor protocol
B. Incomplete data (common in concurrent DUR)
C. Incorrect dosing
D. Lack of counseling

B. Incomplete data (common in concurrent DUR)

A pharmacy implements a new alert system after identifying repeated drug interaction errors. What is the primary goal?
A. Increase dispensing speed
B. Prevent future harm to patients
C. Reduce staffing
D. Increase profits

B. Prevent future harm to patients

Which of the following is NOT directly performed by a pharmacy technician in a DUR process?
A. Notifying pharmacist of suspicious use
B. Reviewing patient medication profiles
C. Assisting workflow for safety
D. Observing refill patterns

B. Reviewing patient medication profiles

A technician reviews a patient’s full medication profile and identifies a drug-drug interaction before dispensing. What is wrong with this scenario?
A. Nothing—this is correct technician duty
B. Technician should only check dosing
C. Technician should alert pharmacist, not perform DUR
D. Technician should override prescription

C. Technician should alert pharmacist, not perform DUR

A pharmacist checks for interactions right before handing the medication to the patient at the counter. What type of DUR is this MOST accurately?
A. Prospective
B. Concurrent
C. Retrospective
D. Preventive

B. Concurrent

Which DUR type happens AFTER the medication has already affected the patient?
A. Prospective
B. Concurrent
C. Retrospective
D. Preventive

C. Retrospective

A pharmacist performs a DUR but skips patient counseling. What requirement is NOT being met?
A. DEA compliance
B. OBRA requirement
C. FDA labeling
D. REMS protocol

B. OBRA requirement

A patient intentionally follows medication instructions as agreed with their provider. What term is BEST?
A. Compliance
B. Adherence
C. Persistence
D. Concordance

B. Adherence

Which DUR type is MOST likely to miss drug interactions due to incomplete patient history?
A. Prospective
B. Concurrent
C. Retrospective
D. Preventive

B. Concurrent

A DUR identifies a medication error and leads to a system-wide policy change. What is the broader benefit?
A. Faster dispensing
B. Reduced staffing needs
C. Prevention of future errors in other patients
D. Increased insurance billing

C. Prevention of future errors in other patients

A pharmacist checks whether a medication is appropriate for a patient’s condition. What DUR factor is this?
A. Drug selection
B. Indications
C. Monitoring
D. Results

B. Indications

A pharmacist evaluates whether the chosen medication is the best option among alternatives. What factor is this?
A. Indications
B. Drug selection
C. Monitoring
D. Administration

B. Drug selection

A patient experiences reduced drug effectiveness due to food intake. What category does this fall under?
A. Drug selection
B. Indications
C. Interactions
D. Monitoring

C. Interactions

A pharmacist verifies how a medication is compounded before dispensing. What factor is being assessed?
A. Administration
B. Preparation
C. Monitoring
D. Results

B. Preparation

A pharmacist ensures the patient understands how much medication to take and how often. What factor is this?
A. Preparation
B. Administration
C. Monitoring
D. Results

B. Administration

A pharmacist explains side effects and how to safely take a medication. What factor is this?
A. Administration
B. Counseling
C. Monitoring
D. Results

B. Counseling

A pharmacist collects lab data over time while a patient is on therapy. What factor is this?
A. Results
B. Monitoring
C. Indications
D. Selection

B. Monitoring

A pharmacist determines whether a medication achieved its intended therapeutic outcome. What factor is this?
A. Monitoring
B. Results
C. Administration
D. Indications

B. Results

A patient suffers severe harm from a medication error that is only discovered months later. Which DUR type failed to prevent this?
A. Prospective
B. Concurrent
C. Retrospective
D. Preventive

C. Retrospective

Which DUR type is MOST effective at preventing errors BEFORE they occur?
A. Retrospective
B. Concurrent
C. Prospective
D. Analytical

C. Prospective

Which DUR type is MOST likely to stop an error at the last possible moment?
A. Prospective
B. Concurrent
C. Retrospective
D. Predictive

B. Concurrent

A DUR evaluates “past prescriptions to ensure correctness and prevent recurrence.” What is this describing?
A. Medication reconciliation
B. Drug utilization review
C. Adverse drug event reporting
D. Therapeutic duplication

B. Drug utilization review

Which of the following is TRUE about DURs?
A. They are only used before dispensing
B. They are only used for billing audits
C. They cover all aspects of medication use and safety
D. They are performed by technicians

C. They cover all aspects of medication use and safety