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Are theophyllines being prescribed effectively and safely in general practice?
1Department of Medicine and General Practice, Queens Medical Centre, Nottingham.
The British Journal of Clinical Practice
|January 1, 1995
Summary
General practitioners (GPs) frequently use theophyllines for respiratory conditions. However, many GPs inadequately monitor theophylline levels and understand factors affecting them, potentially compromising patient safety and treatment effectiveness.
Area of Science:
- General Practice
- Respiratory Medicine
- Pharmacology
Background:
- Theophylline is a bronchodilator used for respiratory diseases.
- Understanding GP practices regarding theophylline use and monitoring is crucial for optimizing patient care.
Purpose of the Study:
- To assess the attitudes and practices of General Practitioners (GPs) in Nottinghamshire concerning the use and therapeutic drug monitoring of theophyllines.
- To identify potential gaps in knowledge and practice that may affect the safety and efficacy of theophylline therapy.
Main Methods:
- A questionnaire survey was distributed to 479 GP principals in Nottinghamshire.
- A reminder was sent to non-responders, achieving a 49% response rate (236 valid responses).
- Data collected included prescribing habits, frequency of theophylline level monitoring, and knowledge of factors influencing drug levels.
Main Results:
- Theophyllines were frequently used as first- or second-line treatments for chronic bronchitis (40%) and nocturnal asthma (24%).
- A significant proportion of GPs rarely or never checked theophylline levels: 76% at initiation and 48% during long-term therapy.
- Half of the respondents could identify only up to 50% of common factors affecting theophylline levels, with no correlation between knowledge scores and prescribing habits in chronic bronchitis, though level monitoring correlated with higher knowledge scores.
Conclusions:
- While theophyllines are prescribed for appropriate indications in general practice, current monitoring practices and understanding of influencing factors may be suboptimal.
- Improving GP awareness of the importance of checking theophylline levels and the factors affecting them could enhance both the safety and effectiveness of this therapy.