Trends in off-label beta-blocker use: a secondary data analysis.


BACKGROUND:The off-label use of beta-blockers might be prevalent, but no studies have provided empiric data on the off-label use based on utilization data. OBJECTIVE:This secondary data analysis was conducted to describe the trends of off-label use of beta-blockers among ambulatory visits made to office-based physicians in the United States. METHODS:Data from the National Ambulatory Medical Care Surveys from 1999 to 2002 were used in this study. Physician visits at which beta-blockers were prescribed (beta-blocker visits) were included and classified as within-label or off-label visits according to whether an approved indication for the beta-blocker was coded for the visits. Variables of patient demographic characteristics, diagnosis, prescriber's specialty, and concomitant medication use were also analyzed. Logistic regression analysis was employed to investigate the potential determinants for the off-label use of beta-blockers. RESULTS:A total of 3349 million visits were made to office-based physicians during the study period. About 65% (2167 million) of all visits were prescribed with > or =1 medication (medication visits). Beta-blockers were prescribed in 5.9% (127.3 million) of all medication visits in the years 1999 to 2002. The 3 most frequently prescribed beta-blockers in this study were atenolol, metoprolol, and propranolol. The proportions of off-label use among beta-blocker visits were 44.3% (1999), 56.3% (2000), 62.3% (2001), and 46.9% (2002); overall, 52.0% (66.2 million). About 11% (75.7 million) of these off-label uses were prescribed to patients with concomitant conditions that required judicious use of beta-blockers. Specialists, such as cardiologists, were more likely to prescribe beta-blockers for off-label use than primary care physicians (odds ratio, 2.147; 95% CI, 2.1464-2.1473). CONCLUSIONS:Our study found that the off-label use rate of beta-blockers was higher than what has been previously reported for other diseases and medications. Compared with visits made to general practitioners, visits made to specialists were more likely to be prescribed off-label use of beta-blockers. Future studies are needed to understand the legal, economic, and clinical impact of off-label use.


Clin Ther


Clinical therapeutics


Lin HW,Phan K,Lin SJ




Has Abstract


2006-10-01 00:00:00


1736-46; discussion 1710-1












  • Randomized, controlled, parallel-group comparison of ambulatory and clinic blood pressure responses to amlodipine or enalapril during and after treatment in adult chinese patients with hypertension.

    abstract:BACKGROUND:Few studies have examined the relative efficacy and tolerability of antihypertensive drug classes in Chinese populations. OBJECTIVE:This study compared the efficacy, tolerability, and duration of antihypertensive effect of amlodipine besylate and enalapril in Chinese patients with hypertension, including el...

    journal_title:Clinical therapeutics

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Tomlinson B,Woo J,Thomas GN,Chau YM,Critchley JA

    更新日期:2004-08-01 00:00:00

  • Hypersensitivity reactions during therapy with the nucleoside reverse transcriptase inhibitor abacavir.

    abstract:BACKGROUND:Hypersensitivity reactions consist of a variable group of clinical findings and have been described for a wide variety of chemical compounds. OBJECTIVE:This review characterizes the clinical profile of hypersensitivity to the nucleoside reverse transcriptase inhibitor abacavir sulfate. METHODS:We performed...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章


    authors: Hetherington S,McGuirk S,Powell G,Cutrell A,Naderer O,Spreen B,Lafon S,Pearce G,Steel H

    更新日期:2001-10-01 00:00:00

  • Fetal Sex, Need for Insulin, and Perinatal Outcomes in Gestational Diabetes Mellitus: An Observational Cohort Study.

    abstract:PURPOSE:This was a prospective observational cohort study that aimed to determine whether fetal sex influences the maternal and fetal outcomes of gestational diabetes mellitus (GDM). METHODS:In this study, 327 European primiparous women were consecutively recruited after diagnosis of GDM. AUC on the oral glucose toler...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章


    authors: Giannubilo SR,Pasculli A,Ballatori C,Biagini A,Ciavattini A

    更新日期:2018-04-01 00:00:00

  • In vitro activity and pharmacodynamics of commonly used antibiotics against adult systemic isolates of Escherichia coli and Pseudomonas aeruginosa at Forty US Hospitals.

    abstract:BACKGROUND:Treatment of infections caused by gram-negative bacilli is increasingly challenging because of emerging resistance. Current surveillance data are informative, but may not discern differences by infection site and clinical setting, and do not incorporate pharmacodynamic (PD) characteristics when determining s...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章,多中心研究


    authors: Eagye KJ,Kuti JL,Sutherland CA,Christensen H,Nicolau DP

    更新日期:2009-11-01 00:00:00

  • Receipt of tetanus-containing vaccinations among adolescents aged 13 to 17 years in the United States: National Immunization Survey-Teen 2007.

    abstract:BACKGROUND:Tetanus-diphtheria-acellular pertussis (Tdap) was licensed in the United States in 2005 to be given in place of tetanus-diphtheria (Td) for single use in adolescents. OBJECTIVES:This analysis was conducted to determine vaccination coverage with Td and Tdap among adolescents in the United States aged 13 to 1...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章


    authors: Jain N,Stokley S,Cohn A

    更新日期:2010-08-01 00:00:00

  • Importance of observational studies in clinical practice.

    abstract:BACKGROUND:In this era of evidence-based medicine, clinicians require a comprehensive range of well-designed studies to support prescribing decisions and patient management. In recent years, data from observational studies have become an increasingly important source of evidence because of improvements in observational...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章,评审


    authors: Ligthelm RJ,Borzì V,Gumprecht J,Kawamori R,Wenying Y,Valensi P

    更新日期:2007-06-01 00:00:00

  • Pharmacokinetic Interaction Between Rosuvastatin, Telmisartan, and Amlodipine in Healthy Male Korean Subjects: A Randomized, Open-label, Multiple-dose, 2-period Crossover Study.

    abstract:PURPOSE:Rosuvastatin, a hydroxy methylglutaryl coenzyme A reductase inhibitor; telmisartan, an angiotensin receptor blocker; and amlodipine, a calcium channel inhibitor, are commonly prescribed together for the treatment of hypertension nonresponsive to monotherapy and accompanied by dyslipidemia. However, the pharmaco...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章,随机对照试验


    authors: Son M,Guk J,Kim Y,Woo Chae D,Heo YA,Soh D,Park K

    更新日期:2016-08-01 00:00:00

  • Effects of hepatic impairment on the steady-state pharmacokinetics of etravirine 200 mg BID: an open-label, multiple-dose, controlled Phase I study in adults.

    abstract:BACKGROUND:Etravirine is a non-nucleoside reverse transcriptase inhibitor (NNRTI) with activity against both wild-type HIV and viruses harboring NNRTI resistance. Etravirine is mainly eliminated via the hepatobiliary route. OBJECTIVES:This study in HIV- patients with mild or moderate hepatic impairment and healthy mat...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章


    authors: Schöller-Gyüre M,Kakuda TN,De Smedt G,Woodfall B,Berckmans C,Peeters M,Hoetelmans RM

    更新日期:2010-02-01 00:00:00

  • Antihypertensive efficacy and tolerability of two fixed-dose combinations of valsartan and hydrochlorothiazide compared with valsartan monotherapy in patients with stage 2 or 3 systolic hypertension: an 8-week, randomized, double-blind, parallel-group tri

    abstract:BACKGROUND:Combination therapy with at least 2 antihypertensive agents is usually needed to achieve appropriate blood pressure (BP) control in patients with isolated or predominant systolic hypertension. A currently recommended combination is a diuretic added to an angiotensin-receptor blocker. OBJECTIVE:This was a st...

    journal_title:Clinical therapeutics

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Lacourcière Y,Poirier L,Hebert D,Assouline L,Stolt P,Rehel B,Khder Y

    更新日期:2005-07-01 00:00:00

  • Effects of branded versus generic terazosin hydrochloride in adults with benign prostatic hyperplasia: a randomized, open-label, crossover study in Taiwan.

    abstract:BACKGROUND:Terazosin is an alpha1-selective adrenoceptor blocking agent that has been reported in many clinical trials to be an effective choice for the treatment of benign prostatic hyperplasia (BPH). To improve cost-effectiveness, the development of an effective and well-tolerated generic formulation is needed. OBJE...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章,随机对照试验


    authors: Tsai YS,Lan SK,Ou JH,Tzai TS

    更新日期:2007-04-01 00:00:00

  • Sparfloxacin: a review.

    abstract:BACKGROUND:The continuing increase in the rate of penicillin and cephalosporin resistance among respiratory pathogens and of cross-resistance to macrolide antibiotics has led to the recommendation that fluoroquinolone antibiotics be used to treat high-risk patients with community-acquired pneumonia (CAP) and acute bact...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章,评审


    authors: Schentag JJ

    更新日期:2000-04-01 00:00:00

  • Optimizing oral medications for children.

    abstract:BACKGROUND:Active pharmaceutical ingredients that taste bitter and/or irritate the mouth and throat are aversive to children as well as many adults. Effective methods of avoiding unpleasant tastes for adults (eg, encapsulating the medicine in pill, capsule, or tablet form) are problematic because many children cannot o...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章,评审


    authors: Mennella JA,Beauchamp GK

    更新日期:2008-11-01 00:00:00

  • Efficacy and tolerability of doxazosin versus enalapril in the treatment of patients with mild-to-moderate hypertension.

    abstract::The effects of 4 weeks of treatment with doxazosin or enalapril on diastolic blood pressure (DBP) and plasma lipid levels were studied in 160 patients 18 to 50 years old with mild-to-moderate hypertension. Comparing baseline measurements with measurements taken after 4 weeks, DBP was significantly reduced by 6.8 +/- 7...

    journal_title:Clinical therapeutics

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Tan KW,Frise SA

    更新日期:1997-05-01 00:00:00

  • Ceftazidime/metronidazole versus netilmicin/metronidazole in the treatment of perforated appendicitis in children.

    abstract::One hundred children with peritonitis resulting from a perforated appendix were treated with ceftazidime or netilmicin. Metronidazole was added to both groups to treat the anaerobic organisms commonly associated with the infecting aerobic organisms in peritonitis. Escherichia coli was the most common aerobe found in p...

    journal_title:Clinical therapeutics

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Kooi GH,Pit S

    更新日期:1990-01-01 00:00:00

  • Cost-minimization analysis of simvastatin versus atorvastatin for maintenance therapy in patients with coronary or peripheral vascular disease.

    abstract:BACKGROUND:Previous health economic studies have demonstrated the cost-effectiveness of simvastatin in the treatment of coronary heart disease (CHD) based on clinical results of the Scandinavian Simvastatin Survival Study. A prior analysis evaluated the "cost of getting to goal," but ignored all costs after titration. ...

    journal_title:Clinical therapeutics

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Attanasio E,Russo P,Allen SE

    更新日期:2001-02-01 00:00:00

  • Efficacy of budesonide in moderate to severe asthma.

    abstract:BACKGROUND:The worldwide prevalence of asthma is increasing by approximately 50% per decade. Budesonide is one of several inhaled corticosteroids available for the treatment of asthma and has been extensively evaluated in clinical trials. OBJECTIVE:This article reviews the published literature on the efficacy of budes...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章,评审


    authors: O'Connell EJ

    更新日期:2002-06-01 00:00:00

  • Adherence to premixed insulin in a prefilled pen compared with a vial/syringe in people with diabetes in Singapore.

    abstract:BACKGROUND:The real-world clinical effectiveness of exogenous insulin is limited by nonadherence. Various insulin delivery systems have been developed to help improve adherence, with prefilled pens gaining popularity among adult Singaporeans with diabetes. However, adherence to insulin in people with diabetes in Singap...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章


    authors: Cheen HH,Lim SH,Huang MC,Bee YM,Wee HL

    更新日期:2014-07-01 00:00:00

  • Relative Bioavailability of Silybin A and Silybin B From 2 Multiconstituent Dietary Supplement Formulations Containing Milk Thistle Extract: A Single-dose Study.

    abstract:PURPOSE:The purpose of this study was to compare the bioavailability between 2 milk thistle-containing dietary supplements, Product B and IsaGenesis, in healthy volunteers. METHODS:Bioavailability between Product B, originally formulated as a powdered capsule, and IsaGenesis, reformulated as a soft gel, were compared ...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章,随机对照试验


    authors: Li WY,Yu G,Hogan RM,Mohandas R,Frye RF,Gumpricht E,Markowitz JS

    更新日期:2018-01-01 00:00:00

  • Translation and validation of the American Urological Association symptom index into Spanish.

    abstract::The US population is multiethnic in composition: many languages thrive, and Spanish is the second most frequently spoken language. The Hispanic population is one of the fastest growing ethnic groups in the United States. The majority of Hispanics speak Spanish at home (63%), and a significant proportion speak little o...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章


    authors: Arocho R,Kason NM,Colón B,McMillan CA

    更新日期:1995-07-01 00:00:00

  • The prevalence of Chlamydia trachomatis in women with genitourinary symptoms.

    abstract::Two studies were conducted to determine the prevalence of Chlamydia trachomatis in the urine and cervical exudates of women with genitourinary symptoms. In the first study, 873 women attending the World Health Organization-Sexually Transmitted Disease Center of the Alfred Fournier Institute, in Paris, were examined. I...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章


    authors: Bohbot JM,Catalan F,Sednaoui P,Siboulet A,Siboulet A

    更新日期:1986-01-01 00:00:00

  • Evaluation of the pharmacokinetics, food effect, pharmacodynamics, and tolerability of DA-1229, a dipeptidyl peptidase IV inhibitor, in healthy volunteers: first-in-human study.

    abstract:BACKGROUND:Inhibitors of dipeptidyl peptidase (DPP) IV are a class of oral hypoglycemic agents that increase glucagon-like peptide-1 (GLP-1) levels by inhibiting its degradation. OBJECTIVE:This study evaluated the pharmacokinetics, pharmacodynamics, and tolerability of DA-1229, which is a newly developed DPP IV inhibi...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章,随机对照试验


    authors: Kim TE,Lim KS,Park MK,Yoon SH,Cho JY,Shin SG,Jang IJ,Yu KS

    更新日期:2012-09-01 00:00:00

  • Domperidone in the management of symptoms of diabetic gastroparesis: efficacy, tolerability, and quality-of-life outcomes in a multicenter controlled trial. DOM-USA-5 Study Group.

    abstract::The purpose of this clinical study was to determine the efficacy, tolerability, and impact on quality of life of domperidone--a specific peripherally acting dopamine antagonist--in the management of symptoms of gastroparesis, a common and potentially debilitating condition in patients with diabetes mellitus. In the fi...

    journal_title:Clinical therapeutics

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Silvers D,Kipnes M,Broadstone V,Patterson D,Quigley EM,McCallum R,Leidy NK,Farup C,Liu Y,Joslyn A

    更新日期:1998-05-01 00:00:00

  • Clinically important drug-disease interactions and their prevalence in older adults.

    abstract:BACKGROUND:Older adults may have decreased homeostatic reserve, have multiple chronic diseases, and take multiple medications. Therefore, they are at risk for adverse outcomes after receiving a drug that exacerbates a chronic disease. OBJECTIVES:The aims of this study were to compile a list of clinically important dru...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章


    authors: Lindblad CI,Hanlon JT,Gross CR,Sloane RJ,Pieper CF,Hajjar ER,Ruby CM,Schmader KE,Multidisciplinary Consensus Panel

    更新日期:2006-08-01 00:00:00

  • Respiratory symptoms due to Branhamella catarrhalis and other Neisseria species infections--response to erythromycin therapy.

    abstract::Neisseria microorganisms (Neisseria lactamica, Neisseria sicca, and Neisseria mucosa) are regarded as normal respiratory commensals. Branhamella catarrhalis (formerly Neisseria catarrhalis) has also been regarded as a normal respiratory commensal, but reports indicate that it can be pathogenic. The role of Neisseria s...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章


    authors: Hamedani P,Hafiz S,Ali J,Memon R,Ali S,Ali M,Ansari M,Siddique I,Raza R

    更新日期:1989-09-01 00:00:00

  • Measuring and monitoring outcomes of disease management programs.

    abstract::After a brief analysis of the financial and health care motives that have led to the current boom in disease management (DM) programs, this paper discusses the pragmatic realities of a particular DM program for treating asthma. A model of the institutional structures necessary for DM to work is presented, emphasizing ...

    journal_title:Clinical therapeutics



    authors: Summers KH

    更新日期:1996-11-01 00:00:00

  • Acid-neutralizing capacity and sodium content of antacid products from Belgium.

    abstract::The acid-neutralizing capacity and sodium content of nine antacid products available in Belgium were evaluated and compared with typical values for Mylanta-II. Liquid and tablets of Mylanta-II have a higher acid-neutralizing capacity per unit dose than do all the other Belgian antacids tested. On a unit dose basis, th...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章


    authors: Gombatz VW

    更新日期:1984-01-01 00:00:00

  • The Nanjing Glycated Hemoglobin Standardization Program: 2012 to 2015.

    abstract:PURPOSE:This study aims to investigate glycosylated hemoglobin (HbA1c), between-laboratory imprecision (%CV), and pass rates from 2012 to 2015 in Nanjing to provide evidence for improving the HbA1c measurement. METHODS:This was a retrospective, descriptive analysis of HbA1c levels obtained from participating hospitals...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章


    authors: Zhang K,Wang Y,Wei H,Xu Z

    更新日期:2017-01-01 00:00:00

  • Potential interactions between cilostazol and probucol: a two-part, single-dose, open-label study in healthy Korean male volunteers.

    abstract:BACKGROUND:Combined therapy with cilostazol, an antiplatelet agent, and probucol, an antihyperlipidemic agent, has been reported to prevent restenosis after percutaneous transluminal coronary angioplasty. However, the potential for pharmacokinetic drug interactions between the 2 agents has not been evaluated. OBJECTIV...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章,随机对照试验


    authors: Kim KP,Kim BH,Lim KS,Kim TE,Shin SG,Jang IJ,Yu KS

    更新日期:2009-10-01 00:00:00

  • Effects of Mycotoxins on Neuropsychiatric Symptoms and Immune Processes.

    abstract:PURPOSE:The effects of air pollutants have been receiving increased attention both clinically and in the media. One such pollutant is mold, fungal growth in the form of multicellular filaments known as hyphae. The growth of molds is omnipresent not only in outdoor settings but also in indoor environments containing exc...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章,评审


    authors: Ratnaseelan AM,Tsilioni I,Theoharides TC

    更新日期:2018-06-01 00:00:00

  • Dosage Optimization of Efavirenz Based on a Population Pharmacokinetic-Pharmacogenetic Model of HIV-infected Patients in Thailand.

    abstract:PURPOSE:Efavirenz exhibits high interindividual variability in plasma concentrations, leading to unpredictable efficacy and toxicity. Polymorphism of CYP2B6 516G > T has been found to predominantly contribute to efavirenz variability. However, dosage recommendations incorporating CYP2B6 516G > T polymorphism have not b...

    journal_title:Clinical therapeutics

    pub_type: 杂志文章


    authors: Chaivichacharn P,Avihingsanon A,Manosuthi W,Ubolyam S,Tongkobpetch S,Shotelersuk V,Punyawudho B

    更新日期:2020-07-01 00:00:00