Motivation:

To identify the potentially inappropriate prescription of loop diuretics as a first-line monotherapy in arterial hypertension of patients over 65 years old in Colombia.

Methods:

Quasiexperimental, prospective, before and after study, without a control group, by means of an educational intervention aimed at prescriptors of patients over 65 years old with the diagnosis of arterial hypertension managed with furosemide in monotherapy, affiliated to the Colombian Health System between January 1st and August 30th 2014. After identifying the patients in a population database of medication dispensation and after the intervention, changes in the formulation were measured.

Results:

Out of a total of 453,017 individuals taking antihypertensives, 160 patients were identified with arterial hypertension being treated with furosemide in monotherapy, with an average age of 82.7 ± 9.1 years. 76 educational activities were carried out with physicians and therapy could be modified in 67 patients (47.8% of intervention participants), where 6.8% discontinued the diuretic, but initiated a new antihypertensive, 13.1% added an antihypertensive and 21.8% definitely suspended the treatment. Being between 65 and 74 years old was associated to a higher probability of success of the intervention (OR: 2.2; CI 95%: 1.010-4.860; p < 0.001).

Conclusions:

A small proportion of patients over 65 years of age were treated with furosemide as antihypertensive monotherapy, but educational strategies and monitorisation of prescriptions may reduce their inappropriate use. It is important to develop tools to motivate the physician to avoid less efficient and safe prescriptions.

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