PURPOSE: Yasmin-28 [ethinyl estradiol 0.03 mg/ @entity4863 3 mg (EE/DRSP)] contains @entity4863 , a progestin component that possesses antimineralocorticoid activity with a @entity972 -sparing diuretic effect similar to that in @entity1482 . Product labeling recommends @entity972 monitoring in the first month of use for @entity1 concurrently receiving medication that may increase serum @entity972 . METHODS: We evaluated compliance with this recommendation by measuring monitoring around the date of oral contraceptive (OC) initiation in @entity1 who received EE/DRSP while being treated with medications predisposing to @entity4144 and in similar @entity1 who received other OCs. Because preliminary analyses indicated incomplete compliance, we surveyed physicians who prescribed EE/DRSP to @entity1 receiving drugs predisposing to @entity4144 on their knowledge and attitudes with regard to the recommendation. We conducted this study using data from the Ingenix Research Datamart, which includes insurance claims for reimbursement for medical services and prescription medications for approximately 8,000,000 members of a large nationally dispersed health plan. We used claims for pharmacy dispensings of prescription medications to identify all @entity1 aged 10-59 years old who initiated EE/DRSP or other OCs during the first 3 years of EE/DRSP availability (July 2001 to June 2004). The frequency of @entity972 monitoring was measured by identifying claims for serum @entity972 tests. We conducted a telephone survey of 58 physicians who had prescribed EE/DRSP up to June 2003 to @entity1 who received concomitant @entity6564 drugs. RESULTS: Although @entity972 monitoring was generally more frequent among EE/DRSP initiators receiving concomitant @entity6564 drugs than among other OC initiators receiving similar medications, only 40% of 466 EE/DRSP initiators with concurrent @entity6564 treatment had @entity972 tests. More than 98% of surveyed physicians were aware of the @entity972 -sparing property of EE/DRSP. Compared with physicians whose @entity1 had @entity972 tests, physicians of @entity1 without such tests were more likely to disagree with the recommendation for users of angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists, heparin and nonsteroidal anti-inflammatory drugs. @entity1 barriers and health plan restrictions were other factors possibly contributing to noncompliance. CONCLUSION: This study demonstrates incomplete physician compliance with a labeling recommendation of @entity972 monitoring for initiators of EE/DRSP receiving concomitant therapy predisposing to @entity4144 . The limited compliance was likely due to a combination of selective physician acceptance of the recommendations and specific @entity1 and health plan barriers to testing.

Serum XXXX monitoring for users of ethinyl estradiol/ @entity4863 taking medications predisposing to @entity4144 : physician compliance and survey of knowledge and attitudes.

@entity1 :: ('9606', 'Species') :: ['women', 'patients', 'patient', 'Patient'] @entity4863 :: ('MESH:C035144', 'Chemical') :: ['drospirenone'] @entity972 :: ('MESH:D011188', 'Chemical') :: ['potassium'] @entity6564 :: ('MESH:D020513', 'Disease') :: ['hyperkalemic'] @entity1482 :: ('MESH:D013148', 'Chemical') :: ['spironolactone'] @entity4144 :: ('MESH:D006947', 'Disease') :: ['hyperkalemia']
@entity972 :: (MESH:D011188,Chemical) :: ['potassium']
