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Drug use for non-hepatic associated conditions in patients with liver cirrhosis

  • M. Isabel Lucena
  • Raúl J. Andrade
  • Gianni Tognoni
  • Ramón Hidalgo
  • Felipe Sanchez de la Cuesta
  • the Spanish Collaborative Study Group on Therapeutic Management in Liver Diseases
Pharmacoepidemiology and Prescription

Abstract

Aims

To study the prescribing patterns of practising physicians for the most frequent non-hepatic associated conditions in patients with liver cirrhosis.

Methods

A multi-centre prospective observational study carried out in 25 Spanish hospitals. Inpatients admitted to gastrointestinal and liver units with a diagnosis of liver cirrhosis were included in five centrally assigned index days, between February and June 1999. Information was collected about pharmacological treatments used on admission and recommended at discharge.

Results

Five hundred and sixty-eight in-patients with a diagnosis of liver cirrhosis (44% alcoholic cirrhosis) and an average number of 2.5 co-morbid conditions were studied: diabetes mellitus (30%), infectious disorders (24%), cardiovascular disease (20%) and active alcoholism (15%)—the most common associated conditions. Chlormethiazole, amoxicillin–clavulanic acid, paracetamol, gliblenclamide, lorazepam, captopril and tiapride were the drugs used most prevalently. The average prescribed daily dose was <1 defined daily dose per day for most medication classes hepatically handled except for calcium channel blockers.

Conclusions

The present study expands current knowledge of prescribing patterns for associated conditions in patients with underlying liver cirrhosis. Drug dosing was affected in general by the influence of age and hepatic disease on the disposition of drugs, but knowledge on drug selection needs further attention.

Keywords

Pharmacoepidemiology Drug use Liver cirrhosis 

Notes

Acknowledgements

This study was in part supported by a research grant from Ministerio de Sanidad y Consumo, Fondo de Investigación Sanitaria, FISS No. 00/1109 and from the Agencia Española del Medicamento. K. Shashok checked the use of English in the manuscript. Participating centres assembled by regions: Andalucia: Hospital Clínico Universitario, Málaga: J.M. Fraile, M.R. Cabello, R. Alcántara, M. García–Cortés—Coordinating centre. Hospital Torrecárdenas, Almeria: M.C. Fernandez, G. Pelaez, J.L. Vega, M. Casado; Hospital Ciudad de Jaen, Jaen: E. Baeyens, M. M. Colmenero; Hospital Puerta del Mar, Cadiz: F. Diaz, P. Rendon, M. Macias; Hospital Reina Sofia, Cordoba: M. de la Mata; Hospital Virgen de las Nieves, Granada: R. Martín–Vivaldi, F. Nogueras; Hospital Puerto Real, Cadiz: J. Perez–Moreno, J.M. Puertas; Hospital Nuestra Sra de Valme, Sevilla: Dr. M. Romero–Gomez, A. Guil, L.Grande; Hospital General de la Axarquia, Velez–Málaga, Málaga: F. Santalla; Hospital Clínico Universitario S. Cecilio, Granada: M.A. Lopez–Garrido, E. Cerilla, J. Salmerón; Aragon: Hospital Clínico Universitario de Zaragoza: M. Simón, M. Villar, A. Lago; Asturias: Hospital Central de Asturias, Oviedo: L. Rodrigo, A. Alvarez–Alvarez, M. García–Espiga; Pais Vasco. Hospital Nuestra Sra de Aranzazu, San Sebastian. M. Garcia Bengoechea, F. Escandi, A. Tejada; Islas Canarias: Hospital Insular Universitario, Gran Canaria: L. Garcia–Villarreal, E. Jiménez, A. Monescillo; Hospital Universitario deTenerife: E. Quintero; Cantabria: Hospital Marqués de Valdecilla, Santander: F. Pons, C. Almohalla, B. de las Heras–Arechavala; Cataluña: Hospital Universitario Germans Trias i Pujol, Barcelona: R. Planas, R. Durandez, M.C. Peña; Hospital Vall d´Hebron, Barcelona: A. Vallano, A. González, J. de la Lama, M. García; Hospital del Mar, Barcelona: C. Hernández–López, M. Farré, R. Solá; Hospital Clinic i Provincial, Barcelona: M. Bruguera, M. Sala; Madrid: Hospital Clínico San Carlos, Madrid: O. Mariscal, E. Vargas, A. Moreno, M. Diaz Rubio; Hospital 12 de Octubre, Madrid: T. Muñoz–Yagüe, I. Salces–Franco, J.A. Solís–Herruzo; Fundación Hospital Alcorcón, Alcorcón, Madrid: J. A. González–Martin, C. Fernandez, G. Cacho–Acosta; Comunidad Valenciana: Hospital General de Valencia: M. Diago, P. Carbonell, V. García; Hospital Arnau de Vilanova, Valencia: O. González López, R. Giner Durán, C. Martínez Lapiedra

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Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • M. Isabel Lucena
    • 1
  • Raúl J. Andrade
    • 1
  • Gianni Tognoni
    • 2
  • Ramón Hidalgo
    • 3
  • Felipe Sanchez de la Cuesta
    • 1
  • the Spanish Collaborative Study Group on Therapeutic Management in Liver Diseases
  1. 1.Clinical Pharmacology Service and Liver Unit, Hospital UniversitarioSchool of Medicine, University of MálagaMálagaSpain
  2. 2.Istituto di Ricerche Pharmacologiche Mario NegriMilanItaly
  3. 3.Centro de CálculoUniversity of MálagaMálagaSpain

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