E-drug: Sampling drugstores (cont) - drugs identifying heart failure patients
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Following on from Dr Offerhaus' note that drug use as an epidemiological
parameter is risky...
I was recently (August 2000) involved in a one-day snapshot study to
review drug management for heart failure for hospital inpatients.
This was done in a large teaching hospital in Australia.
Patients who were taking an ACE inhibitor, frusemide or digoxin were
identified. Of the 366 inpatients in hospital on the snapshot day, 108
patients (30%) were on these drugs. Of these 108 patients, 54 (50%) had
heart failure, either as a comordidity or principle diagnosis (we checked
documentation in the medical record, X-rays and echocardiograms). Of
the 54 heart failure patients, 38 (70%) were on frusemide, 30 (56%)
an ACE
inhibitor, and 22 (41%) digoxin (most also had atrial fibrillation).
Obviously this is a small study, but even in the context of a hospital, it
was difficult to identify the indications for drug therapy and if there was
a history of heart failure. We found we needed to use all three drugs to
identify heart failure patients and half had indications other than heart
failure.
Jonathan Dartnell
Therapeutic Guidelines
Level 2, 55 Flemington Rd, North Melbourne, VIC 3051, Australia
Tel: 03 9326 9959 Fax: 03 9326 5632
website: http://www.tg.com.au
"Jonathan Dartnell" <jdartnell@tg.com.au>
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