Table 2 |
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Number of Inappropriate Prescriptions (%) according to classification by McLeod et al. (of original 38 recommendations). |
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Practice – McLeod Guideline |
Our Definition using drug prescription surrogates |
Inappropriate Prescriptions n (%) |
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Total inappropriate practices – Cardiovascular diseases |
6 (7.2) |
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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) |
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#Prescription of disopyramide to treat atrial fibrillation |
Prescription of disopyramide |
0 (0.0) |
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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) |
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Total inappropriate practices – Psychotropic Drugs |
30 (36.1) |
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*#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) |
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#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) |
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*#Long-term prescription of barbituate to treat insomnia |
Long-term prescription of any barbituate |
1 (1.2) |
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#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) |
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*#Long term prescription of triazolam to treat insomnia |
Long-term prescription of triazolam |
0 (0.0) |
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#Prescription of chlorpromazine to treat psychosis for patients with history of postural hypotension |
Prescription of chlorpromazine |
0 (0.0) |
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#Prescription of nylidrin, niacin, pentoxifylline to treat dementia |
Prescription of nylidrin, niacin or pentoxifylline |
0 (0.0) |
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#Prescription of tricyclic antidepressants with active metabolites to treat depression |
Prescription of tricyclic antidepressants |
17 (20.5) |
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#Prescription of methylphenidate to treat depression |
Prescription of methylphenidate |
0 (0.0) |
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Total inappropriate practices – NSAIDS and other analgesics |
39 (47.0) |
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⊥#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) |
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*Long term prescription of meperidine or pentazocine for pain |
Long term prescription of meperidine or pentazocine |
0 (0.0) |
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⊥#Prescription of NSAIDS to treat osteoarthritis for patients taking warfarin |
Prescription of NSAIDS with warfarin |
3 (3.6) |
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⊥#*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) |
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*#Long term prescription of piroxicam, ketorolac, or mefenamic acid to treat pain |
Long term prescription of piroxicam, ketorolac or mefenamic acid |
0 (0.0) |
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*#γLong term prescription of indomethacin to treat gout |
Long term prescription of indomethacin with gout medication (e.g. allopurinol) |
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⊥#*Long term prescription of NSAIDS to treat osteoarthritis |
Long term prescription of NSAIDS |
18 (21.7) |
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Total inappropriate practices – miscellaneous drugs |
8 (9.6) |
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#Prescription of cimetidine to treat peptic ulcer for patients already receiving warfarin |
Prescription of cimetidine with warfarin |
1 (1.2) |
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#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) |
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#*Long term prescription of diphyenoxylate to treat diarrhea |
Long term prescription of diphenoxylate |
0 (0.0) |
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#Prescription of cyclobenzaprine or methocarbamol to treat muscle spasms |
Prescription of cyclobenzaprin or methocarbamol |
1 (1.2) |
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*Prescribed longer than 2 weeks, +Recommendations from McLeod guidelines grouped together, γRecommendations from McLeod guidelines that were modified by using drug prescriptions as surrogates for disease states #Assumption made that drug only used in treatment of specified disease ⊥Excluding ASA (combination or alone) as an inappropriate prescription, including all other NSAIDS |
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Papaioannou et al. BMC Geriatrics 2002 2:5 doi:10.1186/1471-2318-2-5 |
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