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Abstract #14523 Published in IGR 8-4
Prescription of ocular β-blockers in patients with obstructive pulmonary disease: Does a central electronic medical record make a difference?
Vinker S; Kaiserman I; Waitman DA; Blackman S; Kitai EClinical Drug Investigation 2006; 26: 495-500
OBJECTIVES: Topical β-blockers are contraindicated in obstructive pulmonary diseases (OPDs). In this study we aimed to evaluate through central or local electronic medical records (EMRs) the prescription patterns for topical ocular β-blockers for patients with glaucoma and OPD treated by ophthalmologists. METHODS: The study was carried out at the Leumit Health Maintenance Organisation (HMO) in Israel. The physicians at the HMO all work with an EMR, either a central EMR incorporating data from primary-care physicians and consultants, or a local one. The study population included all HMO members who filled at least one prescription for antiglaucoma medications in 2004. The patients were divided into two groups: those with a previous diagnosis of OPD (ICD-9 codes 493) and those with no known diagnosis of OPD. RESULTS: 7481 patients consumed topical antiglaucoma medications during the study period, and 14.5% had a diagnosis of OPD. 798 OPD patients were treated by ophthalmologists, and of the 61.8% who were treated with topical β-blockers, only 38 received betaxolol. In comparison with glaucoma patients without OPD, OPD patients received fewer β-blockers (p < 0.001), more selective β-blockers (p < 0.0001) and less timolol (p < 0.001). Of the OPD patients treated by ophthalmologists with a central EMR, 59.5% received β-blockers in comparison with 66.4% treated by ophthalmologists with a local EMR (p = 0.06). OPD patients treated by ophthalmologists with a central EMR received more non-β-blockers in comparison with patients treated by ophthalmologists with a local EMR (p = 0.02). CONCLUSION: Most patients with OPD and glaucoma continued to receive topical β-blockers, mostly noncardioselective β-blockers. A central EMR with a comprehensive and highly available medical history reduced the prescription of β-blockers to OPD patients, but rates remained unacceptably high.
Dr. S. Vinker, Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, POB 14238, Ashdod 77042, Israel
Classification:
11.3.4 Betablocker (Part of: 11 Medical treatment > 11.3 Adrenergic drugs)