advertisement
Abstract #19910 Published in IGR 9-4
Co-prescribing of topical and systemic β-blockers in patients with glaucoma: a quality use of medicine issue in Australian practice
Goldberg I; Adena MAClinical and Experimental Ophthalmology 2007; 35: 700-705
PURPOSE: Prescribing topical beta-blockers for patients with glaucoma, who are also being treated with systemic beta-blockers, raises efficacy and safety concerns. This potentially inappropriate co-prescribing practice is a Quality Use of Medicine issue. This study aimed to quantify the extent of co-prescribing of topical and systemic beta-blockers in Australian clinical practice. METHODS: This is a retrospective analysis of de-identified billing data for supply (surrogate marker for prescribing) of topical and systemic beta-blockers from the Pharmaceutical Benefits Scheme (1999-2004) to concessional patients supplied either topical or systemic beta-blockers. The primary outcome was the percentage of patients supplied systemic beta-blockers within the patient population supplied topical beta-blockers. This percentage was calculated for each financial year (July 1999-June 2004), age group (< 65 years; 65-74 years; 75-84 years; ≥85 years) and sex. RESULTS: Approximately 20% of patients supplied topical beta-blockers (representing Australian glaucoma patients) were also supplied systemic beta-blockers, equating to more than 20 000 patients per year. This percentage varied with age, but not with year or sex. The percentage of patients co-supplied topical and systemic beta-blockers was the lowest (13%) for patients < 65 years and the highest (23%) for patients 75-84 years. CONCLUSIONS: Pharmaceutical Benefits Scheme supply data shows that the potentially inappropriate practice of co-prescribing topical and systemic beta-blockers affects more than 20 000 concessional patients in Australia each year, particularly the elderly. This Quality Use of Medicine issue has now been quantified; doctors, pharmacists and patients must be made aware of the reduced efficacy and potential for more side-effects from this co-prescribing practice.
Dr. I. Goldberg, Department of Ophthalmology, Sydney Eye Hospital, University of Sydney, Sydney, New South Wales, Australia
Classification:
11.1 General management, indication (Part of: 11 Medical treatment)
1.4 Quality of life (Part of: 1 General aspects)
11.3.4 Betablocker (Part of: 11 Medical treatment > 11.3 Adrenergic drugs)
