Laboratory monitoring of potassium and creatinine in ambulatory patients receiving angiotensin converting enzyme inhibitors and angiotensin receptor blockers.

Laboratory monitoring of potassium and creatinine in ambulatory patients receiving angiotensin converting enzyme inhibitors and angiotensin receptor blockers. Research Abstract Details 

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Laboratory monitoring of potassium and creatinine in ambulatory patients receiving angiotensin converting enzyme inhibitors and angiotensin receptor blockers. Abstract Text:

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

PURPOSE: Serum potassium and creatinine monitoring is recommended for patients prescribed angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB). Much has been written about hyperkalemia associated with these drugs; little is known about laboratory monitoring patterns. The purpose of this retrospective cohort study was to assess creatinine and potassium monitoring and characteristics associated with monitoring among patients dispensed ACEi or ARB. METHODS: This study was conducted in 10 United States health maintenance organizations. Study patients (n = 52 906) were aged 18 or older with dispensings of ACEi or ARB for at least 1 year. Serum potassium and creatinine monitoring were assessed from administrative data and medical records. RESULTS: More than two-thirds (68.4%) of patients received laboratory monitoring. Likelihood of monitoring increased with age (adjusted odds ratio [OR] 2.10; 95% confidence interval [95%CI] 1.93, 2.28 [individuals >or= 80 compared to <50 years]), >9 outpatient visits (OR 1.46; 95%CI 1.39, 1.54), hospitalization (OR 1.15; 95%CI 1.06, 1.25), concomitant medications (potassium [OR 2.01; 95%CI 1.84, 2.20], diuretics [OR 1.54; 95%CI 1.47, 1.61], digoxin [OR 1.15; 95%CI 1.01, 1.30]), and comorbidities (diabetes [OR 1.68; 95%CI 1.61, 1.75], heart failure [OR 1.73; 95%CI 1.57, 1.90], chronic kidney disease [OR 2.95; 95%CI 2.48. 3.51]). CONCLUSIONS: Nearly one-third of patients dispensed ACEi or ARB did not undergo laboratory monitoring at least yearly. Though patients at increased risk of hyperkalemia were more likely to be monitored, many remained unmonitored.

Laboratory monitoring of potassium and creatinine in ambulatory patients receiving angiotensin converting enzyme inhibitors and angiotensin receptor blockers. Publishing Authors By Initials

MA Raebel,DL McClure,SR Simon,KA Chan,A Feldstein,SE Andrade,JE Lafata,D Roblin,RL Davis,MJ Gunter,R Platt,

For similar investigative techniques: epidemiologic methods: epidemiologic study characteristics as topic: epidemiologic studies: case-control studies: retrospective studies research abstracts see: investigative techniques: epidemiologic methods: epidemiologic study characteristics as topic: epidemiologic studies: case-control studies: retrospective studies research

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Laboratory monitoring of potassium and creatinine in ambulatory patients receiving angiotensin converting enzyme inhibitors and angiotensin receptor blockers. Journal Published:

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

Journal: Pharmacoepidemiology and drug safety

VOLUME: 16

Page Numbers: 55-64

Journal Abbreviation:

ISSN: 1053-8569

DAY: 3

MONTH: Jan

YEAR: 2007

Laboratory monitoring of potassium and creatinine in ambulatory patients receiving angiotensin converting enzyme inhibitors and angiotensin receptor blockers. Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 9208369

Laboratory monitoring of potassium and creatinine in ambulatory patients receiving angiotensin converting enzyme inhibitors and angiotensin receptor blockers. Keywords Mesh Terms:

KEYWORDS: Retrospective Studies

MESH TERMS: blood

Chemical & Substance for Abstract: Laboratory monitoring of potassium and creatinine in ambulatory patients receiving angiotensin converting enzyme inhibitors and angiotensin receptor blockers. Information

Substance Name: Potassium

Registry Number: 7440-09-7

Grant and Affiliation Information for Laboratory monitoring of potassium and creatinine in ambulatory patients receiving angiotensin converting enzyme inhibitors and angiotensin receptor blockers.

AFFILIATION: Kaiser Permanente of Colorado Clinical Research Unit and School of Pharmacy, University of Colorado at Denver and Health Sciences Center, Denver, CO 80237-8066, USA. Marsha.A.Raebel@kp.org

Country: England

AGENCY: United States AHRQ

GRANT: U18 HS11843

ACRONYM: HS

MEDLINETA: Pharmacoepidemiol Drug Saf

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