Patient safety API

Overview

Your patients’ safety is always our top priority. Our Patient safety APIs are the foundation of every step in our pharmacy and telehealth process. While we leverage our own APIs across our internal workflows, we also explore these safety features through our APIs to ensure patient safety is core to your experience.

About URAC

URAC is an organization that helps promote health care quality through the accreditation of organizations involved in medical care services, i.e. pharmacies. It it consider by most as the gold standard in pharmacy accreditation.

Our pharmacies have received the highest level of accreditation in the industry - URAC mail order and URAC specialty accreditation. Of the 60,000+ pharmacies in the country today, only ~60 have received this level of pharmacy accreditation - you are in good hands with us.

URAC’s pharmacy accreditation standards cover core organizational quality, customer service, communications and disclosure, drug utilization management, pharmacy operations, and a process for mail service outcomes measurement and quality improvement.

The URAC-accredited pharmacy:

  • Promotes safety and accuracy in dispensing practices
  • Qualifies all medication distribution processes for appropriate temperature ranges
  • Provides 24/7 patient and prescriber support
  • Complies with foundational standards on risk management, consumer empowerment, and performance management
  • Reports annual performance measures to URAC
  • You can review URAC’s pharmacy Standards-at-a-Glance and Measures-at-a-Glance

How does URAC impact you?

Unlike a typical pharmacy, our URAC accreditation requires us to collect additional clinical information at every refill. These required fields of information include patient current medications, allergies and health conditions as part of the prescription intake process. Additionally, we require this information to be re-collected by your patient at every fill request.

Review URAC PHARM-OP 2 - Prescription Intake Process

Review URAC PM 5 - Periodic Patient Reassessment Process

Patient Survey

As part of being a URAC-accredited pharmacy, you are required to collect specific patient safety details for every fill request you submit. This includes current medications, allergies and health conditions. Each fill request needs to submit updated patient safety details as patient medications, allergies, or conditions may have changed.

You can read more about about our safety standards in our Patient Safety API.

Fill request with patient survey

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Allergy, conditions and drug lookup

You can use the Truepill Patient Safety API to search and retrieve a list of Allergens, Conditions, or Medications for your patient safety experience.

Each of these endpoints work similarly in that you pass in a search `keyword` and you will retrieve a list of related results. Search results will be limited to 50 entries

Search allergies

Patient safety allergy search

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Search conditions

Patient survey conditions search

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Search medications

Patient survey medications search

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Drug utilization

Overview

Drug utilization review (DUR) is defined as an authorized, structured, ongoing review of prescribing, dispensing and use of medication. DUR encompasses a drug review against predetermined criteria that results in changes to drug therapy when these criteria are not met. It involves a comprehensive review of patients' prescription and medication data before, during and after dispensing to ensure appropriate medication decision-making and positive patient outcomes. As a quality assurance measure, DUR programs provide corrective action, prescriber feedback and further evaluations.

DUR is classified in three categories:

Prospective - evaluation of a patient's drug therapy before medication is dispensed

Concurrent - ongoing monitoring of drug therapy during the course of treatment

Retrospective - review of drug therapy after the patient has received the medication

Why is DUR important?

DUR programs play a key role in helping us prioritize your patient's safety. A DUR is used to understand, interpret, evaluate and improve the prescribing, administration and use of medications. Our pharmacists play a key role in this process because of their expertise in the area of medication therapy management. DUR affords our pharmacists the opportunity to identify trends in prescribing within groups of patients whether by disease-state such as those with asthma, diabetes or high blood pressure and initiate action to improve drug therapy for patients as needed.

Prospective DUR

A Prospective DUR involves evaluating a patient's planned drug therapy before a medication is dispensed. This process allows the pharmacist to identify and resolve issues before the patient actually receives the medication. Pharmacists routinely perform prospective reviews in their daily practice by assessing a prescription medication's dosage and directions and reviewing patient information for possible drug interactions or duplicate therapy.

Issues Commonly Addressed by Prospective DUR:

  • Drug-disease contraindications
  • Therapeutic interchange
  • Generic substitution
  • Incorrect drug dosage
  • Inappropriate duration of drug treatment
  • Drug-allergy interactions
  • Clinical abuse/misuse

Example of a Prospective DUR:

A patient being treated with warfarin to prevent blood clots may be prescribed a new drug by another specialist to treat arthritis. If taken together, the patient could experience internal bleeding. Upon reviewing the patient's prescriptions, the pharmacist notes the potential drug interaction and contacts the prescriber to alert him/her to the problem.

Concurrent DUR

A Concurrent DUR is performed during the course of treatment and involves the ongoing monitoring of drug therapy to ensure positive patient outcomes. Some refer to this as case management or health management. It presents pharmacists with the opportunity to alert prescribers to potential problems and to intervene in areas such as drug-drug interactions, duplicate therapy, over or underutilization, and excessive or insufficient dosing. This type of review allows therapy for a patient to be altered if necessary. Concurrent DURs often occurs in institutional settings.

Issues Commonly Addressed by Concurrent DUR:

  • Drug-drug interactions
  • Excessive doses
  • High or low dosages
  • Duplicate therapy
  • Drug-disease interactions
  • Over and underutilization
  • Drug-age precautions
  • Drug-gender precautions

Example of a Concurrent DUR:

Patients in institutional settings often receive multiple medications. Periodic review of patient records can detect actual or potential drug-drug interactions or duplicate therapy. This type of review can also alert the pharmacist to the need for changes in medications such as antibiotics or the need for dosage adjustments based on laboratory test results. The key physician(s) must then be alerted to the situation so that corrective action can be taken.Drug-pregnancy precautions.

Retrospective DUR

A retrospective DUR is the simplest to perform since drug therapy is reviewed after the patient has received the medication. A retrospective review may detect patterns in prescribing dispensing, or administering drugs to prevent recurrence of inappropriate use or abuse and serves as a means for developing prospective standards and target interventions. In retrospective DUR, patient medical charts or computerized records are screened to determine whether the drug therapy met approved criteria and aids prescribers in improving care for their patients, individually and within groups of patients, such as those with diabetes, asthma, or high blood pressure.

Issues Commonly Addressed by Retrospective DUR:

  • Therapeutic appropriateness
  • Over and underutilization
  • Appropriate generic use
  • Therapeutic duplication
  • Drug-disease contraindications
  • Drug-drug interactions
  • Incorrect drug dosage
  • Inappropriate duration of treatment
  • Clinical abuse/misuse

Example of a Retrospective DUR:

An analysis of member prescription utilization may identify of a group of patients whose therapy does not meet approved guidelines. Upon retrospective review the pharmacist may identify a group of patients with asthma who, according to their medical and pharmacy history, should be using orally inhaled steroids. Using this information, the pharmacist can then encourage physicians to prescribe the indicated drugs.

Most common DUR warnings

The most common DUR warning types you will receive from our DUR Request API endpoint include:

  1. (1) Drug-disease contraindications
  2. (2) Drug-allergy interactions
  3. (3) Drug-drug interaction warnings

Below are examples of the responses provided by the Truepill API for these common DUR warning types.

Inputs

Let’s assume a scenario where a patient has an allergy to sildenafil (allergy), a history of low blood pressure (condition), and is currently taking ritonavir and uroxatral (medication). And for this example, let’s say the patient has been prescribed sildenafil.


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Drug-disease contraindication

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Drug-allergy interaction

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Drug-drug interaction

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Create a DUR request

You can use the /dur_request API endpoint to request a drug utilization review from Truepill to determine your patient's safety with a certain medication.

The processing time is synchronous, and on a successful DUR request response, you will receive a summary of the review based on the patient information provided.

Create a DUR request

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DUR Request API Reference →