Urinary Deoxypyridoline (DPD) Concentrations in Pituitary Patients

Abstract

Medical Research Society 5,years) were identified from a random sample of i) discharge prescriptions which included digoxin therapy, or ii) clinical coding of atrial fibrillation on discharge, and confirmed from case notes. Only 44/82 (54%) patients were taking aspirin or warfarin; of the remainder 9 patients had contra-indications to both drugs leaving 29/82 (35%) patients without stroke prevention therapy at discharge. To improve prescribing, ward pharmacists on medical wards were asked to challenge prescriptions for digoxin seen without the co-prescription of warfarin or aspirin. In addition, a sticker was introduced which identified the patient on the prescription card as one who may benefit from anti-thrombotic medication. On re-audit in 1997, 84 patients (49% male, median age 77 years, range 48-91) had atrial fibrillation and 62 (74%) were taking aspirin or warfarin. Of the remainder, 6 patients had contraindications to stroke prevention therapy, leaving 16/84 (1 9%) patients which is significantly lower than before (Chi square4.8, p=0.029) despite the presence of stickers in only 4 sets of notes examined.This study shows that ward pharmacists can help to implement guidelines and improve evidence based practice.Gestational diabetes mellitus (GDM) and impaired glucose tolerance during pregnancy are associated with insulin resistance