Population‐level incidence and monitoring of adverse drug reactions with long‐term amiodarone therapy

Rankin, Stephen; Elder, Douglas; Ogston, Simon; George, Jacob; Lang, Chim C.; Choy, Anna Maria

doi:10.1111/1755-5922.12258

Cited by 10 publications

(7 citation statements)

References 25 publications

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“…The current study found a low rate of CXR follow-up (47.6%), which is consistent with a previous publication (50%) [ 6 ]. A similar result was found regarding LFT follow-up performance (49%), which is in alliance with multiple previous publications (40.5, 52 and 46%) [ 6 , 7 , 9 ]. TFT follow-up was conducted for only 22.4% of the patients included in our study, which is of concern, but consistent with several published studies reporting 32, 20, 16.5 and 28% of TFT follow-up performances [ 6 , 7 , 9 , 10 ].…”

Section: Discussionsupporting

confidence: 92%

“…Forty-eight percent of the patients performed CXR and all patients (100%) conducted ECG [ 8 ]. According to a study performed by Rankin et al, (2017), the recorded adherence was 46% for liver and 28% for thyroid baseline assessments [ 9 ]. The current study found a low rate of CXR follow-up (47.6%), which is consistent with a previous publication (50%) [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

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Compliance with the north American Society of Pacing and Electrophysiology guidelines on amiodarone monitoring in Riyadh, Saudi Arabia: a retrospective charts review study

Albassam

Almutairi

Aldosari

et al. 2020

J of Pharm Policy and Pract

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Background Amiodarone is known for its efficacy as an antiarrhythmic agent; however, its extensive side-effect profile requires careful selection of patients and frequent monitoring. The purpose of this study was to evaluate the performance of the baseline tests before initiating amiodarone therapy and the on-going monitoring based on the North American Society of Pacing and Electrophysiology guidelines recommendations. Methods A retrospective descriptive charts review study included all patients who are 18 years of age and older and were started on oral amiodarone with a primary diagnosis of any type of cardiac arrhythmia from January 2016 to December 2018 in King Abdualziz Medical City, Riyadh, Saudi Arabia. The medical charts were reviewed and evaluated based on the performance of the recommended baseline and follow-up of chest X-ray (CXR), liver function test (LFT), thyroid function test (TFT) and electrocardiogram (ECG). The continuous variables were analyzed and presented as mean ± SD and the categorical variables were presented as percentages. Results Over the study period, 143 eligible participants on amiodarone therapy were included, with an average of 165 ± 207 days on amiodarone. Of patients, 36.4% had the entire recommended baseline assessments before initiating amiodarone. Our results indicated optimal compliance rates to the baseline tests of CXR (79.7%), LFT (79.7%) and ECG (86.7%). However, there was a lower compliance rate to TFT recommendations (40.6%). The compliance rate to the guideline recommendations related to the follow-up tests was minimal. On-going monitoring performance rates were 47.6% of CXR, 49% of LFT, 54.5% of ECG and 22.4% of TFT. Conclusion The compliance with the guideline recommendations related to amiodarone baseline assessments was optimal for all the baseline tests, except for TFT. However, the proportion of patients who received all the recommended baseline assessments was minimal. In addition, the performance of on-going monitoring was suboptimal for all the follow-up tests. Improvements could be made by establishing a local protocol for amiodarone monitoring and pharmacists participating in amiodarone therapy assessments.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Compliance with the north American Society of Pacing and Electrophysiology guidelines on amiodarone monitoring in Riyadh, Saudi Arabia: a retrospective charts review study

Albassam

Almutairi

Aldosari

et al. 2020

J of Pharm Policy and Pract

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“…Regardless of the choice of antiarrhythmia medication, long-term monitoring and patient education is required. This finding is supported by the longitudinal, retrospective population-based study by Rankin et al (2016) that found poor adherence to monitoring guidelines in relation to long-term amiodarone treatment. Toxicity of the thyroid, liver, and lungs were the most common adverse drug reaction with amiodarone.…”

Section: Theme One: Living With Atrial Fibrillationsupporting

confidence: 54%

The understanding and management of stroke risk in patients with atrial fibrillation in Northern British Columbia

Marleau¹

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Atrial fibrillation (AF) affects one percent of the global population, and eight percent of Canadians over the age of sixty-five years. AF is a common predicting factor for ischemic stroke and can cause a five-hundred percent increase in stroke risk. This study aimed to fill a gap in the current literature by investigating a demographic that have not been studied and explored how healthcare providers can improve uptake of preventative measures against stroke. This study investigates the understanding and management of stroke risk in patients with AF living in northern British Columbia through the use of in-depth, semi-structured interviews, using a qualitative-descriptive design. The sample in this study includes twelve participants from three communities in northern British Columbia. Data was analyzed thematically using NVIVO 11 into three separate themes: Living with AF; Stroke Prevention; and Navigation. Results from this research highlight the importance of people diagnosed with AF taking oral anticoagulation and providing education about their increased risk of stroke. iii

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“…thyroid), whereas others may take years to be manifested and occur in a cumulative dose-dependent fashion. [18][19][20] Monitoring of the Patient Receiving Longterm Amiodarone Therapy If amiodarone use is longer than 3 months, the following baseline tests should be obtained: ECG for QT prolongation (avoid if QTc >500 milliseconds) and AV block (avoid if second-degree type II or greater); thyroid function test; liver function test; pulmonary function test; chest radiograph; formal ophthalmologic examination; and initial skin examination. Thyroid and liver function testing should be performed every 6 months.…”

Section: Systemmentioning

confidence: 99%

Antiarrhythmic Drugs for Atrial Fibrillation in the Outpatient Setting: Common Clinical Scenarios and Pearls for the Primary Care Clinician

Tseng

Kowlgi

DeSimone

2021

Mayo Clinic Proceedings

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The management of atrial fibrillation (AF) in the outpatient setting has become more complex with the utilization of antiarrhythmic drugs (AADs) and increasing complexity of comorbid conditions. The primary care clinician is critically involved in the pharmacologic management of AF, whether it be direct prescription of AADs or managing potential drug-drug interactions with other medications. In this review, we provide instructive, high-yield clinical scenarios and quick clinical references to increase familiarity and comfort with the use of AADs.

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Population‐level incidence and monitoring of adverse drug reactions with long‐term amiodarone therapy

Cited by 10 publications

References 25 publications

Compliance with the north American Society of Pacing and Electrophysiology guidelines on amiodarone monitoring in Riyadh, Saudi Arabia: a retrospective charts review study

Compliance with the north American Society of Pacing and Electrophysiology guidelines on amiodarone monitoring in Riyadh, Saudi Arabia: a retrospective charts review study

The understanding and management of stroke risk in patients with atrial fibrillation in Northern British Columbia

Antiarrhythmic Drugs for Atrial Fibrillation in the Outpatient Setting: Common Clinical Scenarios and Pearls for the Primary Care Clinician

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