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Beta blocker prophylaxis for patients with variceal hemorrhage
1Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada. kwilbur@interchange.ubc.ca
Journal of Clinical Gastroenterology
|April 9, 2005
Summary
Beta blocker therapy is underutilized in liver disease patients with varices, missing opportunities for preventing variceal hemorrhage. Optimizing beta blocker use can improve care for these high-risk patients.
Area of Science:
- Hepatology
- Gastroenterology
- Clinical Pharmacology
Background:
- Variceal hemorrhage is a severe complication of portal hypertension in liver disease.
- Beta blockers are proven to reduce the risk of first and recurrent variceal bleeding and mortality.
Purpose of the Study:
- To characterize the use of beta blocker therapy for primary and secondary prevention of variceal hemorrhage in liver disease patients.
Main Methods:
- Retrospective review of 106 liver disease patients hospitalized with suspected variceal hemorrhage.
Main Results:
- Only 20% of patients received beta blockers at admission, and 48% at discharge.
- The majority (94%) were not receiving therapy for primary prophylaxis.
- Patients with >2 prior hemorrhages were more likely to be on beta blockers at admission (73% vs. 41%).
Conclusions:
- Beta blocker therapy is underutilized in liver disease patients with varices for preventing variceal hemorrhage.
- There is a significant gap in the standard of care for prophylactic beta blocker use.
- Optimizing beta blocker therapy presents an opportunity to improve patient outcomes.