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August 14, 2002

Inappropriate Prescription for Metformin—Reply

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor

JAMA. 2002;288(6):694-695. doi:10.1001/jama.288.6.693

In Reply: In response to Dr Molitch, we used medication records as an initial screening tool, but confirmed the diagnosis of CHF through an extensive medical record review, including clinical diagnoses, echocardiograms, and chest radiograph results. While the exact indication of medications can be difficult to interpret, and ACE inhibitors are indicated for many patients with diabetes, all of the 17 patients with CHF in our study were also taking a diuretic or digoxin. While these 2 medications are occasionally prescribed for other indications, they were most likely prescribed for symptoms of CHF.

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