The 10 Most Frequently Observed PPOs
| PPO Description | Percentage of Total PPOs (N = 55,578)a | |
|---|---|---|
| 1. | Start laxatives in patients receiving opioids regularly | 14.7 |
| 2. | Start ACE inhibitor with systolic heart failure and/or documented coronary artery disease | 7.9 |
| 3. | Start statin therapy with a documented history of coronary, cerebral, or peripheral vascular disease, unless patient has end-of-life status or is >85 years old | 7.4 |
| 4. | Start ACE inhibitor or ARB (if intolerant of ACE inhibitor) in diabetes with evidence of renal disease, that is, dipstick proteinuria or microalbuminuria (>30 mg/24 hours) with or without serum biochemical renal impairment | 7.1 |
| 5. | Start metformin twice a day with diabetes mellitus type 2 if eGFR is 30-50 mL/min/1.73m2, not if < 30 mL/min/1.73m2 | 6.5 |
| 6. | Start antiplatelet therapy (aspirin, clopidogrel, prasugrel, or ticagrelor) with a documented history of coronary, cerebral, or peripheral vascular disease | 5.9 |
| 7. | Start aspirin (75-160 mg once daily) in the presence of chronic atrial fibrillation, where vitamin K antagonists or direct thrombin inhibitors or factor Xa inhibitors are contraindicated | 5.6 |
| 8. | Start β-blocker with ischemic heart disease | 5.1 |
| 9. | Start vitamin D supplement in older adults who are housebound, are experiencing falls, or have osteopenia (bone mineral density T-score is greater than −2.5 but less than −1.0 in multiple sites) | 4.9 |
| 10. | Start regular inhaled β2 agonist or antimuscarinic bronchodilator (eg, ipratropium, tiotropium) for mild to moderate asthma or COPD | 4.8 |
ACE = angiotensin-converting enzyme; ARB = angiotensin receptor blocker; COPD = chronic obstructive pulmonary disease; eGFR = estimated glomerular filtration rate; PPO = potential prescribing omission.
Note: PPOs provide information on correct prescribing according to the Screening Tool to Alert doctors to Right Treatment (START) criteria.
↵a Unique PPOs per patient over 6 years.