Development, implementation and cost-effectiveness of a protocol for review of combination diuretic prescribing.
OBJECTIVE
To determine the extent of inappropriate prescribing of combination diuretics and the cost implications of protocol implementation.


METHODS
Pharmacist-run medication review clinics in two general practices in Bradford, UK.


RESULTS
Sixty-one patients, mean +/- s.d. age 75.8 +/- 12.0 years, were reviewed. Thirty-six met protocol criteria; 30 (49.2%) patients had their potassium-sparing diuretics (PSDs) discontinued. Mean (95% confidence interval) reduction in serum potassium concentrations after intervention in these 30 patients was 0.26 (0.09, 0.43) mmol l(-1) (P < 0.01). Twenty-eight (93.3%) patients were within the reference range at follow-up; none was below.


CONCLUSIONS
Of prescribed PSDs, 59% were found to be unnecessary. Using the developed protocol potentially improves drug safety and enables cost savings.
Morgan
Julie D
JD
School of Pharmacy, University of Bradford, Bradford, UK. j.d.morgan@bradford.ac.uk
Wright
David J
DJ
Chrystyn
Henry
H
George
Bethan
B
Booth
Andrew C
AC
Shoesmith
David J
DJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002985:Clinical Protocols; D003362:Cost-Benefit Analysis; D004232:Diuretics / Q000008:administration & dosage* / Q000191:economics; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood
D004232:Diuretics; D004338:Drug Combinations; D011188:Potassium