Table 2 Number of Inappropriate Prescriptions (%) according to classification by McLeod et al. (of original 38 recommendations).
Practice – McLeod Guideline | Our Definition using drug prescription surrogates | Inappropriate Prescriptions n (%) |
|---|---|---|
Total inappropriate practices – Cardiovascular diseases | 6 (7.2) | |
γ#Prescription of B-adrenergic blocking agent to treat hypertension for patients with history of asthma or COPD | Prescription of B-adrenergic blocking agent with B-agonist or bronchial anti-inflammatory agent | 5 (6.0) |
#Prescription of disopyramide to treat atrial fibrillation | Prescription of disopyramide | 0 (0.0) |
γ#Prescription of thiazide diuretic to treat hypertension for patients with history of gout | Prescription of thiazide diuretics with gout medication (e.g. allopurinol) | 1 (1.2) |
Total inappropriate practices – Psychotropic Drugs | 30 (36.1) | |
*#Long-term prescription of long half-life benzodiazepine to treat insomnia | Long-term prescription of any long half-life benzodiazepine (e.g. valium) | 4 (4.8) |
#γPrescription of tricyclic antidepressants to treat depression for patients with history of glaucoma, benign prostatic hyperplasia, or heart block | Prescription of tricyclic antidepressant with glaucoma or prostate medication | 8 (13.6) |
*#Long-term prescription of barbituate to treat insomnia | Long-term prescription of any barbituate | 1 (1.2) |
#Prescription of selective serotonin reuptake inhibitor for patients already receiving a monoamine oxidase inhibitor to treat depression | Prescription of selective serotonin reuptake inhibitor for patients already receiving a monoamine oxidase inhibitor | 0 (0.0) |
*#Long term prescription of triazolam to treat insomnia | Long-term prescription of triazolam | 0 (0.0) |
#Prescription of chlorpromazine to treat psychosis for patients with history of postural hypotension | Prescription of chlorpromazine | 0 (0.0) |
#Prescription of nylidrin, niacin, pentoxifylline to treat dementia | Prescription of nylidrin, niacin or pentoxifylline | 0 (0.0) |
#Prescription of tricyclic antidepressants with active metabolites to treat depression | Prescription of tricyclic antidepressants | 17 (20.5) |
#Prescription of methylphenidate to treat depression | Prescription of methylphenidate | 0 (0.0) |
Total inappropriate practices – NSAIDS and other analgesics | 39 (47.0) | |
⊥#γPrescription of NSAIDS to treat osteoarthritis for patients with a history of peptic ulcer | Prescription of NSAIDS with histamine 2 antagonists or proton pump inhibitors | 5 (6.0) |
*Long term prescription of meperidine or pentazocine for pain | Long term prescription of meperidine or pentazocine | 0 (0.0) |
⊥#Prescription of NSAIDS to treat osteoarthritis for patients taking warfarin | Prescription of NSAIDS with warfarin | 3 (3.6) |
⊥#*γ+Long-term prescription of NSAIDS to treat osteoarthritis for patients with history of heart failure or hypertension | Prescription of NSAIDS with diuretics | 13 (15.7) |
*#Long term prescription of piroxicam, ketorolac, or mefenamic acid to treat pain | Long term prescription of piroxicam, ketorolac or mefenamic acid | 0 (0.0) |
*#γLong term prescription of indomethacin to treat gout | Long term prescription of indomethacin with gout medication (e.g. allopurinol) | |
⊥#*Long term prescription of NSAIDS to treat osteoarthritis | Long term prescription of NSAIDS | 18 (21.7) |
Total inappropriate practices – miscellaneous drugs | 8 (9.6) | |
#Prescription of cimetidine to treat peptic ulcer for patients already receiving warfarin | Prescription of cimetidine with warfarin | 1 (1.2) |
#Prescription of anticholinergic drugs to prevent extrapyramidal effects of antipsychotic drugs | Prescription of anticholinergic drugs (e.g. congentin) with antipsychotic drugs (e.g. risperdal) | 6 (7.2) |
#*Long term prescription of diphyenoxylate to treat diarrhea | Long term prescription of diphenoxylate | 0 (0.0) |
#Prescription of cyclobenzaprine or methocarbamol to treat muscle spasms | Prescription of cyclobenzaprin or methocarbamol | 1 (1.2) |