title: Replacing short-acting nifedipine with alternative medications at a large health maintenance organization.
abstract: In response to recent evidence about the safety of calcium channel blockers, Group Health Cooperative of Puget Sound (GHC), a large health maintenance organization, implemented a plan in April 1996 to reevaluate the medications of 1349 patients who were taking short-acting nifedipine. Following the intervention, 79.8% of patients taking short-acting nifedipine discontinued use, and 45.6% switched to once-daily felodipine. By presenting physicians and patients with recent evidence about the safety of short-acting nifedipine, a large health maintenance organization was able to motivate broad-scale changes to safer alternative drug therapies.
authors.affiliation: Cardiovascular Health Research Unit, Department of Epidemiology, University of Washington, Seattle 98101, USA. rkaplan@u.washington.edu
authors.forename: R C
authors.initials: RC
authors.lastname: Kaplan
authors.forename: B M
authors.initials: BM
authors.lastname: Psaty
authors.forename: D
authors.initials: D
authors.lastname: Kriesel
authors.forename: S R
authors.initials: SR
authors.lastname: Heckbert
authors.forename: N L
authors.initials: NL
authors.lastname: Smith
authors.forename: C
authors.initials: C
authors.lastname: Gillett
authors.forename: A G
authors.initials: AG
authors.lastname: Golston
mesh_terms: D000368:Aged; D002121:Calcium Channel Blockers / Q000009:adverse effects* / Q000627:therapeutic use; D015331:Cohort Studies; D003692:Delayed-Action Preparations; D004363:Drug Utilization / Q000639:trends; D015736:Felodipine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006279:Health Maintenance Organizations; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D009543:Nifedipine / Q000009:adverse effects* / Q000627:therapeutic use; D019233:Retreatment; D012449:Safety
chemical_list: D002121:Calcium Channel Blockers; D003692:Delayed-Action Preparations; D009543:Nifedipine; D015736:Felodipine