Inappropriate prescription of allopurinol in a teaching hospital.
BACKGROUND
Allopurinol is a drug that is widely used to treat hyperuricemia, but it is often prescribed inappropriately.


OBJECTIVE
The authors conducted a study to look for the appropriate allopurinol prescription and diagnosis of gout in the out-patient clinics at a university hospital.


METHODS
One hundred and forty-five patients who were newly prescribed allopurinol (128 males and 17 females, mean +/- SD age of 58.5 +/-14.1 years) were enrolled in this study.


RESULTS
Only 77 (53.1%) received allopurinol with appropriate indications. Thirty-eight patients (26.2%) did not have allopurinol dose adjustment according to the patients' creatinine clearance. Among 131 patients, prescribed allopurinol for the diagnosis of gout, only 55 (42.0%) were diagnosed in accordance with the American Rheumatism Association criteria.


CONCLUSIONS
Inappropriate use of allopurinol (both the indication and prescribed dosage) and inappropriate diagnosis of gout are major problems even in a large teaching hospital. An educational campaign program is warranted for achieving appropriate diagnosis of gout, and eliminating the inappropriate use of allopurinol.
Athisakul
Siriporn
S
Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Wangkaew
Suparaporn
S
Louthrenoo
Worawit
W
D000368:Aged; D000493:Allopurinol / Q000627:therapeutic use*; D011307:Drug Prescriptions; D017723:Drug Utilization Review; D005260:Female; D006074:Gout Suppressants / Q000627:therapeutic use*; D006300:Health Services Misuse; D006784:Hospitals, Teaching / Q000592:standards; D006801:Humans; D033461:Hyperuricemia / Q000175:diagnosis* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000592:standards*; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D013785:Thailand
D006074:Gout Suppressants; D000493:Allopurinol