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Clinical Drug Investigation

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01-09-2006 | Original Research Article

Prescription of Ocular β-Blockers in Patients with Obstructive Pulmonary Disease

Does a Central Electronic Medical Record Make a Difference?

Authors: Dr Shlomo Vinker, Igor Kaiserman, Dan Andrei Waitman, Shimon Blackman, Eliezer Kitai

Published in: Clinical Drug Investigation | Issue 9/2006

Abstract

Objectives: Topical β-blockers are contraindicated in obstructive pulmonary diseases (OPDs). In this study we aimed to evaluate through central or local electronic medical records (EMRs) the prescription patterns for topical ocular β-blockers for patients with glaucoma and OPD treated by ophthalmologists.

Methods: The study was carried out at the Leumit Health Maintenance Organisation (HMO) in Israel. The physicians at the HMO all work with an EMR, either a central EMR incorporating data from primary-care physicians and consultants, or a local one. The study population included all HMO members who filled at least one prescription for antiglaucoma medications in 2004. The patients were divided into two groups: those with a previous diagnosis of OPD (ICD-9 codes 493) and those with no known diagnosis of OPD.

Results: 7481 patients consumed topical antiglaucoma medications during the study period, and 14.5% had a diagnosis of OPD. 798 OPD patients were treated by ophthalmologists, and of the 61.8% who were treated with topical β-blockers, only 38 received betaxolol. In comparison with glaucoma patients without OPD, OPD patients received fewer β-blockers (p < 0.001), more selective β-blockers (p < 0.0001) and less timolol (p < 0.001). Of the OPD patients treated by ophthalmologists with a central EMR, 59.5% received β-blockers in comparison with 66.4% treated by ophthalmologists with a local EMR (p = 0.06). OPD patients treated by ophthalmologists with a central EMR received more non-β-blockers in comparison with patients treated by ophthalmologists with a local EMR (p = 0.02).

Conclusion: Most patients with OPD and glaucoma continued to receive topical β-blockers, mostly noncardioselective β-blockers. A central EMR with a comprehensive and highly available medical history reduced the prescription of β-blockers to OPD patients, but rates remained unacceptably high.

The use of trade names is for product identification purposes only and does not imply endorsement.

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Title: Prescription of Ocular β-Blockers in Patients with Obstructive Pulmonary Disease
Does a Central Electronic Medical Record Make a Difference?
Authors: Dr Shlomo Vinker
Igor Kaiserman
Dan Andrei Waitman
Shimon Blackman
Eliezer Kitai
Publication date: 01-09-2006
Publisher: Springer International Publishing
Published in: Clinical Drug Investigation / Issue 9/2006
Print ISSN: 1173-2563
Electronic ISSN: 1179-1918
DOI: https://doi.org/10.2165/00044011-200626090-00002

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