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Quality Assurance Policies and Procedures
KelseyCare Advantage’s Quality Assurance Processes are designed to help ensure the safety and effectiveness of care related to prescription drugs. These processes focus on preventing medication errors, avoiding adverse drug events or interactions, and optimizing medication use. Important Quality Assurance Processes are described below.
Drug Utilization ReviewConcurrent Drug Utilization Review (“DUR”) checks are intended to screen for potential safety issues (including the examples in the bulleted list below) before you receive your prescription, and is performed before or at the same time that the prescription is dispensed, typically at the pharmacy.
Retrospective Drug Utilization Review (“RDUR”) is a review of your prescription drug that is performed on a regular basis, analyzing our computerized prescription data and other records to help identify and avoid potential medication issues. If our review identifies any such issues, we will work with your physician to correct the problem. Examples of the potential medication issues our DUR and RDUR programs are designed to detect and prevent include the following:
- Unnecessarily taking more than one drug to treat the same medical condition
- Drugs that may not be appropriate because of your age or gender
- Taking too much or too little of a certain drug
- Potentially harmful interactions between two drugs you are taking
- Incorrect drug dosage
- Allergic reactions to drugs
- Taking a drug for an inappropriate reason or in an incorrect manner