Laboratory evaluation of potassium and creatinine among ambulatory patients prescribed spironolactone: are we monitoring for hyperkalemia?

Laboratory evaluation of potassium and creatinine among ambulatory patients prescribed spironolactone: are we monitoring for hyperkalemia? Research Abstract Details 

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Laboratory evaluation of potassium and creatinine among ambulatory patients prescribed spironolactone: are we monitoring for hyperkalemia? Abstract Text:

Marsha A Raebel,David L McClure,K Arnold Chan,Steven R Simon,Adrianne C Feldstein,Jennifer Elston Lafata,Susan E Andrade,Margaret J Gunter,Winnie W Nelson,Douglas Roblin,Richard Platt,

BACKGROUND: Serum potassium and creatinine evaluation is recommended in patients prescribed spironolactone, yet the proportion of ambulatory patients chronically dispensed spironolactone receiving evaluation is not well understood. OBJECTIVE: To estimate the rate of potassium and creatinine evaluation and identify factors associated with conducting these tests among ambulatory patients dispensed spironolactone. METHODS: A retrospective cohort study was designed to evaluate patients at 10 health maintenance organizations with ongoing spironolactone dispensing for one year (N = 2257). Potassium and creatinine evaluation were determined from administrative data. Associations between patient characteristics and laboratory testing were assessed, using logistic regression modeling. RESULTS: Serum creatinine and potassium were evaluated in 72.3% of patients during a 13 month period. The likelihood of potassium and creatinine monitoring was greater among patients who were older (OR 1.28; 95% CI 1.17 to 1.41 per decade of life); male (OR 1.25; 95% CI 1.01 to 1.54); had diabetes (OR 1.63; 95% CI 1.31 to 2.03); received concomitant therapy with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (OR 2.23; 95% CI 1.74 to 2.87), potassium supplements (OR 1.96; 95% CI 1.51 to 2.54), or digoxin (OR 2.10 95% CI 1.48 to 2.98); or had more outpatient visits (OR 1.31; 95% CI 1.19 to 1.44). Among patients with heart failure (n = 790), factors associated with the incidence of laboratory testing were diabetes (OR 1.64, 95% CI 1.14 to 2.34), outpatient visits (OR 1.20; 95% CI 1.02 to 1.41), and digoxin therapy (OR 2.26; 95% CI 1.38 to 3.69). CONCLUSIONS: Three-fourths of ambulatory patients dispensed spironolactone receive recommended laboratory evaluation, with monitoring more likely to be completed in patients prescribed concomitant therapy with drugs that increase hyperkalemia risk, older patients, and those with diabetes.

Laboratory evaluation of potassium and creatinine among ambulatory patients prescribed spironolactone: are we monitoring for hyperkalemia? Publishing Authors By Initials

MA Raebel,DL McClure,KA Chan,SR Simon,AC Feldstein,JE Lafata,SE Andrade,MJ Gunter,WW Nelson,D Roblin,R Platt,

For similar organic chemicals: lactones: spironolactone research abstracts see: organic chemicals: lactones: spironolactone research

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MEDLINE DATE:

Laboratory evaluation of potassium and creatinine among ambulatory patients prescribed spironolactone: are we monitoring for hyperkalemia? Journal Published:

PUBLICATION TYPE: Research Support, U.S. Gov't,

Journal: The Annals of pharmacotherapy

VOLUME: 41

Page Numbers: 193-200

Journal Abbreviation:

ISSN: 1542-6270

DAY: 6

MONTH: 02

YEAR: 2007

Laboratory evaluation of potassium and creatinine among ambulatory patients prescribed spironolactone: are we monitoring for hyperkalemia? Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 9203131

Laboratory evaluation of potassium and creatinine among ambulatory patients prescribed spironolactone: are we monitoring for hyperkalemia? Keywords Mesh Terms:

KEYWORDS: Spironolactone

MESH TERMS: therapeutic use

Chemical & Substance for Abstract: Laboratory evaluation of potassium and creatinine among ambulatory patients prescribed spironolactone: are we monitoring for hyperkalemia? Information

Substance Name: Potassium

Registry Number: 7440-09-7

Grant and Affiliation Information for Laboratory evaluation of potassium and creatinine among ambulatory patients prescribed spironolactone: are we monitoring for hyperkalemia?

AFFILIATION: Kaiser Permanente Colorado Clinical Research Unit and School of Pharmacy, University of Colorado at Denver and Health Sciences Center, Denver, CO 80237, USA. Marsha.A.Raebel@kp.org

Country: United States

AGENCY: United States AHRQ

GRANT: U18 HS 11843

ACRONYM: HS

MEDLINETA: Ann Pharmacother

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