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Diuretics a top admissions cause

By Danusia Osiowy

Diuretics are the second most common cause of preventable, drug-related hospital admissions, ahead of a series of known high-risk drug classes, a new study reveals.

The NHS-funded research found diuretics were responsible for nearly one in six of all preventable admissions from primary care, marginally behind antiplatelets and ahead of NSAIDs and anticoagulants (see box, right).

The top four drug classes together accounted for 50 per cent of all preventable admissions, raising hopes that limited changes to prescribing behaviour could bring substantial benefits to patients.

Professor Tony Avery, a researcher on the study and head of the primary care division at the University of Nottingham medical school, said: 'We were surprised diuretics featured so prominently as these are commonly used and not usually considered as dangerous as some of the other drugs featured. The biggest risks here

are for older patients with multiple morbidities, such as heart failure.'

He added: 'The fact 50 per cent of admissions were associated with just four groups of drugs suggests the risk for these groups is far higher than that of the majority of other drugs that we commonly use.'

Professor Avery said he was trying to persuade Connecting for Health of the need for improved computerised prescribing support for GPs, taking into account the new data.

The research is the most comprehensive to date to detail the drugs most commonly implicated in preventable, drug-related hospital admissions. One-third were associated with prescribing problems, one-third with patient adherence to medication and almost a quarter with inadequate monitoring of medication, the analysis showed.

Dr George Rae, a GP in

Newcastle and a member of

the GPC prescribing subcommittee, said: 'GPs can take steps to intervene within these drug groups. Pharmacists involved with medicine management are a promising step forward.'

Dr Brian Crichton, a GP in Solihull and RCGP prescribing adviser, added: 'The education of non-medical prescribers is of the utmost importance.'

The systematic review, published online by the Journal of Clinical Pharmacology, analysed data on 17 studies on preventable drug-related hospital admissions, including five from the UK.

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