OBJECTIVE: To examine patterns of use of acetaminophen in patients with and without risk factors for hepatotoxicity in the Ohio Medicaid population. DESIGN: Retrospective, cross-sectional analysis of claims data. SETTING: Ohio. PATIENTS: Ohio Medicaid patients (n = 22,496) who received at least 6 prescriptions for acetaminophen from November 1998 through April 1999. MAIN OUTCOME MEASURE: Overuse of acetaminophen, defined as an average daily dose (ADD) greater than or equal to 4 grams/day or an ADD of greater than or equal to 3 grams/day along with diagnosis codes suggesting underlying liver dysfunction. RESULTS: We identified 687 patients (3.05%) who received either greater than or equal to 4 grams/day or greater than or equal to 3 grams/day and had diagnosis codes suggesting underlying liver dysfunction (n = 128). CONCLUSION: Although the number is relatively small, some Ohio Medicaid patients are receiving acetaminophen doses that exceed safety recommendations. Because acetaminophen overuse is the leading cause of liver failure, health care professionals should be alert to the possibility of acetaminophen overuse.
OBJECTIVE: To examine patterns of use of acetaminophen in patients with and without risk factors for hepatotoxicity in the Ohio Medicaid population. DESIGN: Retrospective, cross-sectional analysis of claims data. SETTING: Ohio. PATIENTS: Ohio Medicaid patients (n = 22,496) who received at least 6 prescriptions for acetaminophen from November 1998 through April 1999. MAIN OUTCOME MEASURE: Overuse of acetaminophen, defined as an average daily dose (ADD) greater than or equal to 4 grams/day or an ADD of greater than or equal to 3 grams/day along with diagnosis codes suggesting underlying liver dysfunction. RESULTS: We identified 687 patients (3.05%) who received either greater than or equal to 4 grams/day or greater than or equal to 3 grams/day and had diagnosis codes suggesting underlying liver dysfunction (n = 128). CONCLUSION: Although the number is relatively small, some Ohio Medicaid patients are receiving acetaminophen doses that exceed safety recommendations. Because acetaminophen overuse is the leading cause of liver failure, health care professionals should be alert to the possibility of acetaminophen overuse.
Authors: Alexander A Leung; Carol Keohane; Stuart Lipsitz; Eyal Zimlichman; Mary Amato; Steven R Simon; Michael Coffey; Nathan Kaufman; Bismarck Cadet; Gordon Schiff; Diane L Seger; David W Bates Journal: J Am Med Inform Assoc Date: 2013-04-18 Impact factor: 4.497