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Evaluation of ACE‐inhibitor (ACE‐I) associated cough using modified prescription sequence analysis (PSA)
Author(s) -
Bowman Lee,
Carlstedt Bruce C.,
Miller Michael E.,
McDonald Clement J.
Publication year - 1995
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.2630040108
Subject(s) - medicine , medical prescription , odds ratio , lisinopril , captopril , ambulatory , retrospective cohort study , confidence interval , cohort , cohort study , angiotensin converting enzyme , pharmacology , blood pressure
Abstract Objective — Identify whether the prescription sequence of cough suppressant within one year following patients' first ACE‐I prescription can be used as an indicator for the occurrence of ACE‐I associated cough. Design — Observational retrospective controlled cohort design using all patients receiving ACE‐I as study cohort and patients having prescriptions for hydralazine, clonodine and prazosin as the control. Patient demographics and prescribing indications were controlled statistically using multivariate logistic regression. Setting — A large computerized clinical database encompassing the medical records of 450,000 patients seen over a 20‐year period at a county medical centre ambulatory clinic. Patients — 5373 patients exposed to any of captopril, enalapril, lisinopril, clonodine, hydralazine or prazosin. Main results — This study identified an odds ratio (OR) of 1.53 [95% confidence interal (CI) 1.17 to 2.01] for receipt of an antitussive following patients' first ACE‐I prescription. Other significant risk factors included female gender [OR = 1.52, CI 1.13 to 2.07] and diagnosis of congestive heart failure [OR = 1.47, CI 1.10 to 1.94]. Conclusion — The receipt of an antitussive following ACE‐I prescription may be used to monitor for ACE‐I associated cough, although its utility is unknown.