Baclofen Prescribing Practice and Its Appropriateness in an Outpatient Setting of a Tertiary Hospital
Introduction: Reports of baclofen toxicity in patients with severe renal impairment have raised concerns regarding prescribing practice of the drug in the outpatient department. The aim of this study is to determine the incidence of inappropriate prescribing of baclofen and its prescribing pattern. Method: This was a retrospective, observational study of prescriptions from July to December 2014 in an outpatient clinic of a public hospital in Malaysia. All prescriptions containing baclofen were selected and records of these patients were retrieved and reviewed. Where available, results of serum creatinine were also collected. Appropriateness of baclofen use was determined by 3 independent doctors based on labelled indication of baclofen. Result: Out of 65,922 prescriptions screened, 691 (1.1%) prescriptions which contained baclofen and whose records could be retrieved were included in the analysis. Most of the prescriptions were for pain (78.2%) and contained at least one pain medication. Baclofen was prescribed concomitantly with NSAIDs, antihypertensives and oral hyperglycaemic agents in 535 (77.4%), 49 (7.1%) and 25 (3.6%) cases respectively. Two patients had kidney failure. The overall proportion of inappropriate use of baclofen was high (n = 641, 92.7%). Although the trend of baclofen use reduced drastically after September 2014, possibly due to stricter prescribing practices that was enforced in the department, the proportion of its inappropriate use remained high. Conclusion: Inappropriate use of baclofen is prevalent. Rigorous interventions such as trainings should be carried out to avoid future preventable overdoses or toxicities.