Tjia, JenniferFischer, Shira H.Raebel, Marsha A.Peterson, Daniel J.Zhao, YanfangGagne, Shawn J.Gurwitz, Jerry H.Field, Terry S.2022-08-232022-08-232011-09-012011-09-15Ann Pharmacother. 2011 Sep;45(9):1077-84. Epub 2011 Aug 18. <a href="http://dx.doi.org/10.1345/aph.1Q158">Link to article on publisher's site</a>1060-0280 (Linking)10.1345/aph.1Q15821852593https://hdl.handle.net/20.500.14038/33216BACKGROUND: Laboratory monitoring of medications is typically used to establish safety prior to drug initiation and to detect drug-related injury following initiation. It is unclear whether black box warnings (BBWs) as well as evidence- and consensus-based clinical guidelines increase the likelihood of appropriate monitoring. OBJECTIVE: To determine the proportion of patients newly initiated on selected cardiovascular medications with baseline assessment and follow-up laboratory monitoring and compare the prevalence of laboratory testing for drugs with and without BBWs and guidelines. METHODS: This cross-sectional study included patients aged 18 years or older from a large multispecialty group practice who were prescribed a cardiovascular medication (angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, amiodarone, digoxin, lipid-lowering agents, diuretics, and potassium supplements) between January 1 and July 31, 2008. The primary outcome measure was laboratory test ordering for baseline assessment and follow-up monitoring of newly initiated cardiovascular medications. RESULTS: The number of new users of each study drug ranged from 49 to 1757 during the study period. Baseline laboratory test ordering across study drugs ranged from 37.4% to 94.8%, and follow-up laboratory test ordering ranged from 20.0% to 77.2%. Laboratory tests for drugs with baseline laboratory assessment recommendations in BBWs were more commonly ordered than for drugs without BBWs (86.4% vs 78.0%, p < 0.001). Drugs with follow-up monitoring recommendations in clinical guidelines had a lower prevalence of monitoring (33.1% vs 50.7%, p < 0.001). CONCLUSIONS: Baseline assessment of cardiovascular medication monitoring is variable. Quality measurement of adherence to BBW recommendations may improve monitoring.en-USJournal Articlehttps://escholarship.umassmed.edu/gsbs_sp/17532239514gsbs_sp/1753