Prescription of diuretic drugs and monitoring of long-term use in one general practice.

A cross-sectional survey of the prescription and monitoring of diuretic drugs for long-term use was performed in a Nottinghamshire training practice, which has 7619 patients. It was found that 330 patients were long-term users of diuretic drugs, with 79% of these patients aged 60 years or over. Twenty three different diuretic drugs were prescribed with a total cost of 13,643 pounds per year. A few drugs accounted for a disproportionate amount of the total cost, with combination diuretic drugs being particularly expensive. The most common indications for the prescription of diuretic drugs were hypertension and congestive cardiac failure. General practitioners initiated the prescribing of diuretic drugs in 87% of cases, with only a small proportion being prescribed by hospital doctors. One third of the patients had no record of urea and electrolyte levels in their notes after commencing treatment with a diuretic drug. On the basis of these findings recommendations are made for the initiation and monitoring of the long-term use of diuretic drugs.