Evaluation of preventable adverse drug reactions by implementation of the nationwide network of prospective drug utilization review program in Korea

PLoS One. 2018 Apr 11;13(4):e0195434. doi: 10.1371/journal.pone.0195434. eCollection 2018.


Background: A prospective Drug Utilization Review (DUR) program has been implemented in Korea to improve the quality and safety of medication use.

Objective: To evaluate the influence of the DUR program in reducing incidence of preventable adverse drug reactions (pADRs).

Methods: This study was performed using administrative data from the Health Insurance Review and Assessment Service (HIRA). The claims data for all adult patients with adverse drug events (ADE)-related diagnoses from 2009 to 2014 were obtained. Incidence rates of first-time and repeat pADRs prior to and after DUR program implementation were evaluated. Quarterly trends in incidence rates of overall ADE, allergic reactions, and ADRs were analyzed.

Results: Data extraction covering the period from 2009 to 2014 led to the identification of 3,927,662 records. First-time pADR rates decreased gradually after implementation of the DUR program (change in slope: -0.016, p = 0.02). The program had a similar influence on repeat pADR rates (change in slope: -0.006, p≤0.01). The program did not decrease rates of first-time or repeat allergic reactions (change in slope: 0.018, p = 0.07 and 0.003, p = 0.04, respectively). In the cohort aged ≤65 years, first-time pADR rate reduction was significant (28.2% [27.1-29.3] in ≤18 years, and 19.8% [18.1-21.5] in 19-64 years). In contrast, first-time pADR rate was increased by 0.6% [-0.7-1.9] in patients ≥65 years.

Conclusion: Implementation of the prospective DUR program effectively reduced the number of pADRs. In the future, to reduce non-preventable ADRs such as allergic reactions, provision of clinical information including allergy history should be added to the DUR program.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Aged
  • Drug-Related Side Effects and Adverse Reactions / prevention & control*
  • Electronic Health Records / statistics & numerical data*
  • Female
  • Humans
  • Insurance, Health / statistics & numerical data
  • Male
  • Middle Aged
  • Republic of Korea
  • Young Adult

Grants and funding

This research was supported by the Bio & Medical Technology Development Program of the National Research Foundation funded by the Ministry of Science, ICT & Future Planning, Republic of Korea (No. 2013M3A9B5075838) and the Health Insurance Review and Assessment Service (No. 2015-99).