Development, implementation and cost-effectiveness of a protocol for review of combination diuretic prescribing

Br J Clin Pharmacol. 2003 Mar;55(3):317-20. doi: 10.1046/j.1365-2125.2003.01784.x.

Abstract

Aims: To determine the extent of inappropriate prescribing of combination diuretics and the cost implications of protocol implementation.

Methods: Pharmacist-run medication review clinics in two general practices in Bradford, UK.

Results: Sixty-one patients, mean +/- s.d. age 75.8 +/- 12.0 years, were reviewed. Thirty-six met protocol criteria; 30 (49.2%) patients had their potassium-sparing diuretics (PSDs) discontinued. Mean (95% confidence interval) reduction in serum potassium concentrations after intervention in these 30 patients was 0.26 (0.09, 0.43) mmol l(-1) (P < 0.01). Twenty-eight (93.3%) patients were within the reference range at follow-up; none was below.

Conclusions: Of prescribed PSDs, 59% were found to be unnecessary. Using the developed protocol potentially improves drug safety and enables cost savings.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Clinical Protocols
  • Cost-Benefit Analysis
  • Diuretics / administration & dosage*
  • Diuretics / economics
  • Drug Combinations
  • Female
  • Humans
  • Male
  • Middle Aged
  • Potassium / blood

Substances

  • Diuretics
  • Drug Combinations
  • Potassium