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Year : 2019  |  Volume : 20  |  Issue : 3  |  Page : 121-124

Cardiovascular and respiratory considerations with topical beta-blockers: is it really old news?

1 Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle, UK; Ophthalmology Department, Faculty of Medicine, Minia University, Al Minia, Egypt, UK
2 Northumbria NHS Trust
3 NHS Dumfries and Galloway

Correspondence Address:
PhD, FRCS Mahmoud Nassar
Royal Victoria Infirmary, Newcastle
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/DJO.DJO_27_19

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Objective The aim of this study was to identify the prevalence of prescribing topical beta-blockers (TBB) despite documented contraindications in general practice and whether patients were involved in decisions about treatment. Design This was a primary-care-based cross-sectional descriptive study. Introduction Glaucoma is one of the commonest causes of irreversible blindness in the United Kingdom, causing ∼5.9% of blind registration. TBB are currently considered the best adjunctive treatment and are well known for their systemic effects. The effect of concurrent prescription of TBB with systemic contraindications was found to significantly increase the rate of hospitalization and emergency room visits. Patients and methods Electronic medical records of four primary care providers in the North East of England were searched for primary open-angle glaucoma, use of TBB, and known systemic contraindications. Included records were further searched for correspondence from ophthalmology departments to primary care. We contacted those patients whose records showed no documentation of communicating potential risks with patients and rationale of using TBB. Results Of the 49 816 patients registered with the four primary health care providers, 798 (1.6%) had primary open-angle glaucoma. Of these, 279 (35%) were prescribed TBB; 260 (93.2%) of whom had no systemic contraindications. Conclusion Nineteen (6.8%) patients with systemic contraindications were prescribed TBB despite alerts from electronic medical records. Furthermore, these patients were not made aware of the potential risk.

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