AVAILABILITY OF SAMPLE MEDICATIONS AND RESIDENTS PRESCRIBING PATTERNS. J. Diaz 1 , M.J. Fagan 1 , A. Etienne 1 ; 1 Brown University, Providence, RI PURPOSE: The use of sample medications in clinical teaching settings is controversial. One concern is that the presence of sample medications may affect physician compliance with treatment guidelines. This project examined the availability of anti-hypertension sample medications and the selection of specific medications by internal medicine residents to treat hypertension. METHODS: From 12/4/00 to 12/20/00, charts of patients presenting to the residents' clinic at Rhode Island Hospital were reviewed if hypertension was listed as one of their diagnoses and the patients were receiving medications. All anti-hypertension medications prescribed, the date of visit and insurance status of each patient were recorded. During the same time period, inventory of the clinic's medication sample closet was taken for each clinic session and names of all antihypertension medications available were noted. RESULTS: During the 3 week period, 288 patient charts met criteria for review. 56% (161/ 288) of patients had no insurance coverage for medications. A total of 41 different blood pressure medications were documented as being prescribed and 18 (44%) of these were available as samples. The 5 most commonly prescribed medications were hydrochlorothiazide (86/288), Norvasc (amlodipine-73/288), Accupril (quinapril-66/288), Vasotec (enalapril-42/288) and Toprol XL (metoprolol-32/288). Three of these, Norvasc (amlodipine), Accupril (quinapril), and Toprol XL (metoprolol) were available in the sample closet during the study period and one, Vasotec (enalapril), had recently been available. Except for diuretics, for each class of antihypertension medication, the most commonly prescribed agent was also available as a sample. Of 146 notations of ACE-Is, 65 (44.5%) were Accupril (quinapril). Of 118 calcium-channel blockers (CCBs) prescribed, 70 (59%) were Norvasc (amlodipine). Of 65 notations of betablocker use, 31 (48%) were Toprol XL (metoprolol). No diuretics were available as samples, but the diuretic most commonly prescribed was a generic agent, hydrochlorothiazide (70%, 84/120). Stratifying by medication coverage, a sample closet CCB and a sample closet ACE-I continued to be the medications most commonly prescribed in their drug classes. Norvasc (amlodopine) accounted for 54% (38/70) of CCBs prescribed to patients without medication coverage and 67% (32/48) of patients with coverage. Accupril (quinapril) accounted for 42% (36/85) of ACE-I prescribed to patients without coverage and 47% (29/61) of patients with coverage. CONCLUSION: This pilot study suggests that residents selecting medications to treat hypertension may be influenced by the availability of sample medications. With the exception of hydrochlorothiazide, for each class of anti-hypertension medication, a drug available in the sample closet was the one most commonly prescribed. Although this reflects patterns at only one institution, residency programs should be aware of how sample medications may influence the prescribing patterns of physicians in training.