A Drug Utilization Research on Aminophylline/ Theophylline in Ali-Asghar Hospital, Shiraz, Southern Iran

Background: Drug utilization research (DUR) is an effective program to identify variability in drug use and to support interventions that will improve patient outcomes. The appropriate use of aminophylline/theophylline was evaluated in Shiraz, southern Iran. Methods: A prospective DUR study was conducted in Ali-Asghar Hospital from April 2005 to April 2007. All inpatient cases of asthma or COPD who were started on IV loading dose of aminophylline were included in the study. A blood sample was provided from the patients at steady state condition just before the next dose, in order to determine the trough serum concentration of the drug. Demographic characteristics of patients, along with clinical and paraclinical findings, lab data, drug history, and adverse drug events were recorded using their files and a face to face interview. Results: One hundred patients were enrolled among them, 57% (n=57) were female and 43% (n=43) were male. The age range was 16-90 years with mean age±SD of 65.63±14.7. Diagnosis was asthma in 46% and COPD in 54% of patients. Theophylline serum concentration range was 0-37 mcg/ml (7.94±5.4). Ninety eight percent of patients had at least one adverse event due to aminophyline or theophylline use. 14 items were evaluated for aminophylline/theophyline administration and compared to a standard guideline. The mean score for 100 patients included in the study was 8 out of 14. Conclusions: The most considerable problem in aminophylline/theophylline usage in our hospital was ignorance to the important role of pharmacokinetics in optimizing aminophylline/theophylline therapeutic response and minimizing ADEs and the cost of hospitalization. Training of the healthcare providers is recommended. Performing population pharmacokinetic studies will be a good guidance for improving aminophylline/theophylline usage in our population.