Building blocks and evaluation in QUM programs MCQs With Answer

Introduction: Building blocks and evaluation in Quality Use of Medicines (QUM) programs is a vital topic for M.Pharm students preparing to design, implement, and assess interventions that ensure safe, effective, and rational medicine use. This blog provides a focused set of multiple-choice questions to reinforce core concepts — the structural building blocks of QUM (policy, governance, workforce, information systems, essential medicines, financing, and community engagement) and rigorous evaluation methods (indicators, study designs, data sources, and analysis). These MCQs aim to deepen understanding of practical metrics, monitoring tools, and evaluation approaches used in real-world QUM programs, preparing students for research and program management roles.

Q1. What is considered the foundational policy instrument for guiding national Quality Use of Medicines (QUM) programs?

• Therapeutic interchange policy
• National Medicines Policy
• Hospital formulary list
• Clinical audit protocol

Correct Answer: National Medicines Policy

Q2. Which component is NOT typically listed among the core building blocks of a QUM program?

• Essential medicines list and standard treatment guidelines
• Workforce training and capacity building
• Pharmaceutical marketing regulations
• Health information systems and monitoring

Correct Answer: Pharmaceutical marketing regulations

Q3. The DU90% (Drug Utilization 90%) indicator primarily measures which aspect of medicine use?

• Cost-effectiveness of therapies
• Proportion of total prescribing accounted for by the top 90% of drugs
• Adherence rates among chronic patients
• Antimicrobial resistance trends

Correct Answer: Proportion of total prescribing accounted for by the top 90% of drugs

Q4. Which evaluation design is most appropriate to assess the impact of a national QUM policy implemented at one time point across a whole country?

• Randomized controlled trial
• Interrupted time series analysis
• Cross-sectional survey
• Case-control study

Correct Answer: Interrupted time series analysis

Q5. In DDD/1000 inhabitants/day metrics, “DDD” stands for:

• Drug Daily Dose
• Defined Daily Dose
• Diagnosed Drug Dose
• Drug Dispensing Data

Correct Answer: Defined Daily Dose

Q6. Which indicator would best measure prescribing quality for antibiotics in outpatient settings?

• Percentage of prescriptions with at least one antibiotic
• Number of unique antibiotics in the formulary
• Average cost per prescription
• Hospital antibiotic consumption only

Correct Answer: Percentage of prescriptions with at least one antibiotic

Q7. A Drug Utilization Evaluation (DUE) primarily focuses on which of the following?

• Developing new drugs
• Assessing appropriateness, safety, and cost-effectiveness of drug use
• Evaluating pharmaceutical industry profits
• Lab-based pharmacokinetic studies

Correct Answer: Assessing appropriateness, safety, and cost-effectiveness of drug use

Q8. Which data source is least useful for monitoring outpatient medicine use at a population level?

• National health insurance claims databases
• Community pharmacy dispensing records
• Hospital inpatient medication charts only
• Electronic prescribing records from primary care

Correct Answer: Hospital inpatient medication charts only

Q9. In QUM program evaluation, “process indicators” typically measure:

• Long-term clinical outcomes like mortality
• Immediate actions taken, such as guideline adherence and training delivery
• Pharmaceutical market share
• National GDP spent on medicines

Correct Answer: Immediate actions taken, such as guideline adherence and training delivery

Q10. Which is the best description of “implementation fidelity” in evaluation of a QUM intervention?

• The cost per patient treated
• Degree to which the intervention was delivered as intended
• Number of stakeholders consulted during planning
• Difference between rural and urban prescribing

Correct Answer: Degree to which the intervention was delivered as intended

Q11. The ATC/DDD system is useful for international comparisons because it:

• Reports doses prescribed by brand name
• Standardizes units of drug consumption across settings
• Measures patient adherence directly
• Predicts clinical outcomes

Correct Answer: Standardizes units of drug consumption across settings

Q12. Which evaluation method is most suitable to explore why a QUM intervention achieved its outcomes from participants’ perspectives?

• Cost-effectiveness analysis
• Randomized controlled trial
• Qualitative interviews and focus groups
• Ecological time series

Correct Answer: Qualitative interviews and focus groups

Q13. Which of the following is a key outcome indicator for assessing chronic disease medicine use?

• Proportion of patients achieving target blood pressure or glycemic control
• Number of new drugs launched annually
• Average pharmacy opening hours
• National pharmaceutical advertising spend

Correct Answer: Proportion of patients achieving target blood pressure or glycemic control

Q14. Benchmarking in QUM programs is primarily used to:

• Develop new medications
• Compare performance against standards or peers to drive improvement
• Estimate drug shelf-life
• Create marketing materials for prescribers

Correct Answer: Compare performance against standards or peers to drive improvement

Q15. Which economic evaluation method compares costs and health outcomes in natural units (like life-years gained) and is often used in QUM program assessments?

• Cost-minimization analysis
• Cost-utility analysis using QALYs
• Cost-effectiveness analysis
• Budget impact analysis only

Correct Answer: Cost-effectiveness analysis

Q16. Which indicator best reflects rational prescribing at a prescriber level?

• Percentage of prescriptions including an injectable when not indicated
• Number of pharmaceutical representatives visiting clinics
• Pharmacy stock turnover rate
• Total national medication expenditure

Correct Answer: Percentage of prescriptions including an injectable when not indicated

Q17. Which intervention has strong evidence for improving prescriber behavior and rational medicine use?

• Passive distribution of printed guidelines only
• Academic detailing (personalized educational outreach)
• Pharmaceutical-sponsored gifts to prescribers
• One-time mass media campaigns without follow-up

Correct Answer: Academic detailing (personalized educational outreach)

Q18. When designing an evaluation, which principle helps link program activities to expected short-, medium-, and long-term outcomes?

• Random allocation
• Theoretical saturation
• Logic model or theory of change
• Intention-to-treat analysis

Correct Answer: Logic model or theory of change

Q19. Measuring adherence at a population level can be done using:

• Pharmacy refill rates or medication possession ratio (MPR)
• Only patient self-report without triangulation
• Counting number of prescriptions written per clinic visit
• Annual number of medical conferences held

Correct Answer: Pharmacy refill rates or medication possession ratio (MPR)

Q20. In mixed-methods evaluation of a QUM program, the primary advantage is:

• It eliminates the need for quantitative data
• Combines numeric outcome measures with contextual understanding from qualitative data
• Reduces evaluation costs to zero
• Ensures causality without a comparison group

Correct Answer: Combines numeric outcome measures with contextual understanding from qualitative data

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