COMPUTERIZED DRUG-USE EVALUATION

A drug-use evaluation (DUE) of angiotensin-converting-enzyme (ACE) inh ibitors by both manual and computerized methods was conducted. Criteri a for the use of ACE inhibitors were developed and approved. Fifty pat ients were randomly selected from 225 clinic outpatients who had begun taking an ACE inhibitor during a six-month period. The clinic medical records of each of the patients were reviewed by a pharmacist to dete rmine compliance with the DUE criteria. At the same time, a computer p rogram queried the computerized medical records of the same patients t o evaluate adherence to the criteria. The manual method showed that AC E inhibitor therapy met threshold for two of the six criteria before e xceptions were considered and for three criteria after exceptions were considered. Results for only two criteria met threshold when evaluate d by the computer; the computer did not consider exceptions. There was good or excellent percent agreement between the manual and computeriz ed methods for four of the six criteria. Kappa values showed that the agreement for five criteria was significant. A computerized method of evaluating drug use performed similarly to manual evaluation, but agre ement was best for simply stated criteria.