Medical Research: What is the background for this study? What are the main findings?
Dr. Mostaghimi: Spironolactone, a generic drug that’s been used in the clinic since 1959, is commonly prescribed for treating hormonal acne – acne that tends to affect the jaw line most commonly around the time of the month when a woman gets her period. The US Food and Drug Administration recommends frequent potassium monitoring in patients with heart failure who are taking spironolactone as a diuretic and antihypertensive treatment, but it’s been unclear if these guidelines should apply to healthy patients taking spironolactone for the treatment of acne, and, if so, how frequently such patients should have their potassium levels tested.
My colleagues and I have found that for young, healthy women taking spironolactone to treat hormonal acne, potassium monitoring is an unnecessary health care expense. For the approximately 1,000 patients we studied, blood tests to monitor potassium levels did not change the course of treatment, but the tests cumulatively totaled up to $80,000. We suggest that routine potassium monitoring should no longer be recommended for this patient population in order to improve the patient care experience, decrease unnecessary office visits and reduce health care spending.
Medical Research: What should clinicians and patients take away from your report?
Dr. Mostaghimi: We hope that by presenting these data, we will begin to create a standard of practice that best serves patients and helps physicians who may be ambivalent about recommending these tests for otherwise healthy patients. The low rate of hyperkalemia that we found in this patient population may encourage more health care professionals to consider the use of this highly effective drug in their clinical practice.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Mostaghimi: As we begin to consider the costs of care, it is important to systematically re-evaluate our practices to make sure that our prescribing and monitoring practices provide the greatest value possible. Future research needs to continue to challenge our assumptions to make sure we provide the best care possible at the lowest possible price.
Plovanich M, Weng Q, Mostaghimi A. Low Usefulness of Potassium Monitoring Among Healthy Young Women Taking Spironolactone for Acne. JAMA Dermatol. Published online March 22, 2015. doi:10.1001/jamadermatol.2015.34.
MedicalResearch.com Interview with: Dr. Arash Mostaghimi, MD, MPA (2015). Acne: Potassium Monitoring May Not Be Necessary For Spironolactone Therapy