Information de reference pour ce titreAccession Number: | 01445491-200701000-00009.
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Author: | Raebel, Marsha A. PharmD 1,*; McClure, David L. PhD 2; Simon, Steven R. MD, MPH 3; Chan, Arnold K. MD, ScD 4; Feldstein, Adrianne MD, MS 5; Andrade, Susan E. ScD 6; Lafata, Jennifer Elston PhD 7; Roblin, Douglas PhD 8; Davis, Robert L. MD, MPH 9; Gunter, Margaret J. PhD 10; Platt, Richard MD, MS 11
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Institution: | (1)Kaiser Permanente of Colorado Clinical Research Unit and School of Pharmacy, University of Colorado at Denver and Health Sciences Center, Denver, CO, USA (2)Kaiser Permanente of Colorado Clinical Research Unit, Denver, CO, USA (3)Harvard Pilgrim Health Care and Harvard Medical School, Boston, MA, USA (4)i3 Magnifi Epidemiology, Auburndale, Massachusetts and Harvard School of Public Health, Boston, MA, USA (5)Kaiser Permanente Northwest Center for Health Research and Oregon Health Sciences University, Portland, OR, USA (6)Meyers Primary Care Institute, Fallon Foundation and University of Massachusetts Medical School, Worcester, MA, USA (7)Henry Ford Health System, Detroit, MI, USA (8)Kaiser Permanente of Georgia, Atlanta, GA, USA (9)Group Health Cooperative Center for Health Studies and University of Washington Department of Epidemiology, Seattle, Washington, USA (10)Lovelace Clinic Foundation, Albuquerque, NM, USA (11)Harvard Pilgrim Health Care, Channing Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA (*)Correspondence to: Kaiser Permanente of Colorado, Clinical Research Unit, PO Box 378066, Denver, CO 80237-8066, USA.
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Title: | |
Source: | Pharmacoepidemiology & Drug Safety. 16(1):55-64, January 2007.
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Abstract: | Purpose: Serum potassium and creatinine monitoring is recommended for patients prescribed angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB). Much has been written about hyperkalemia associated with these drugs; little is known about laboratory monitoring patterns. The purpose of this retrospective cohort study was to assess creatinine and potassium monitoring and characteristics associated with monitoring among patients dispensed ACEi or ARB.
Methods: This study was conducted in 10 United States health maintenance organizations. Study patients (n = 52 906) were aged 18 or older with dispensings of ACEi or ARB for at least 1 year. Serum potassium and creatinine monitoring were assessed from administrative data and medical records.
Results: More than two-thirds (68.4%) of patients received laboratory monitoring. Likelihood of monitoring increased with age (adjusted odds ratio [OR] 2.10; 95% confidence interval [95%CI] 1.93, 2.28 [individuals >= 80 compared to <50 years]), >9 outpatient visits (OR 1.46; 95%CI 1.39, 1.54), hospitalization (OR 1.15; 95%CI 1.06, 1.25), concomitant medications (potassium [OR 2.01; 95%CI 1.84, 2.20], diuretics [OR 1.54; 95%CI 1.47, 1.61], digoxin [OR 1.15; 95%CI 1.01, 1.30]), and comorbidities (diabetes [OR 1.68; 95%CI 1.61, 1.75], heart failure [OR 1.73; 95%CI 1.57, 1.90], chronic kidney disease [OR 2.95; 95%CI 2.48. 3.51]).
Conclusions: Nearly one-third of patients dispensed ACEi or ARB did not undergo laboratory monitoring at least yearly. Though patients at increased risk of hyperkalemia were more likely to be monitored, many remained unmonitored. Copyright (C) 2006 John Wiley & Sons, Ltd.
Copyright (C) 2007 John Wiley & Sons, Inc.
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Author Keywords: | angiotensin converting enzyme inhibitor; angiotensin receptor blocker; potassium; creatinine; laboratory monitoring; ambulatory care.
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Language: | English.
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Document Type: | Research Articles.
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Journal Subset: | Pharmacology.
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ISSN: | 1053-8569
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DOI Number: | https://dx.doi.org/10.1002/pds.1...- ouverture dans une nouvelle fenêtre
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