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Co‐prescribing of topical and systemic beta‐blockers in patients with glaucoma: a quality use of medicine issue in Australian practice
Author(s) -
Goldberg Ivan,
Adena Michael A
Publication year - 2007
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/j.1442-9071.2007.01573.x
Subject(s) - medicine , pharmaceutical benefits scheme , glaucoma , population , beta blocker , medical prescription , heart failure , ophthalmology , pharmacology , environmental health
A bstract Purpose: Prescribing topical beta‐blockers for patients with glaucoma, who are also being treated with systemic beta‐blockers, raises efficacy and safety concerns. This potentially inappropriate co‐prescribing practice is a Quality Use of Medicine issue. This study aimed to quantify the extent of co‐prescribing of topical and systemic beta‐blockers in Australian clinical practice. Methods: This is a retrospective analysis of de‐identified billing data for supply (surrogate marker for prescribing) of topical and systemic beta‐blockers from the Pharmaceutical Benefits Scheme (1999–2004) to concessional patients supplied either topical or systemic beta‐blockers. The primary outcome was the percentage of patients supplied systemic beta‐blockers within the patient population supplied topical beta‐blockers. This percentage was calculated for each financial year (July 1999–June 2004), age group (<65 years; 65–74 years; 75–84 years; ≥85 years) and sex. Results: Approximately 20% of patients supplied topical beta‐blockers (representing Australian glaucoma patients) were also supplied systemic beta‐blockers, equating to more than 20 000 patients per year. This percentage varied with age, but not with year or sex. The percentage of patients co‐supplied topical and systemic beta‐blockers was the lowest (13%) for patients <65 years and the highest (23%) for patients 75–84 years. Conclusions: Pharmaceutical Benefits Scheme supply data shows that the potentially inappropriate practice of co‐prescribing topical and systemic beta‐blockers affects more than 20 000 concessional patients in Australia each year, particularly the elderly. This Quality Use of Medicine issue has now been quantified; doctors, pharmacists and patients must be made aware of the reduced efficacy and potential for more side‐effects from this co‐prescribing practice.