QTc prolongation in acute medical admissions: an often overlooked and potentially serious finding

Coughlan, J J; Wafer, Meghan; Fitzgerald, G; Nawaz, A.; O’Brien, Claire; Liston, Richard

doi:10.1136/postgradmedj-2017-135208

Cited by 3 publications

(1 citation statement)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The risk of drug-induced QT interval prolongation appears to be frequently overlooked in clinical practice [6]. Pharmacists are in the ideal position to identify and prevent this risk while conducting medication reviews [7].…”

Section: Introductionmentioning

confidence: 99%

Identification of Patients At-Risk of QT Interval Prolongation during Medication Reviews: A Missed Opportunity?

Buss

Lee

Naunton

et al. 2018

JCM

View full text Add to dashboard Cite

The prolongation of the QT interval is a relatively rare but serious adverse drug reaction. It can lead to torsade de pointes, which is potentially life-threatening. The study’s objectives were: determine the use of QT interval-prolonging drugs in an elderly community-dwelling population at risk of medication misadventure and identify recommendations regarding the risk of QT interval prolongation made by pharmacists when performing medication reviews. In a retrospective evaluation, 500 medication review reports from Australian pharmacists were analysed. In patients taking at least one QT interval-prolonging drug, the individual risk of drug-induced QT interval prolongation was assessed. Recommendations of pharmacists to avoid the occurrence of this drug-related problem were examined. There was a high prevalence of use of potentially QT interval-prolonging drugs (71% patients), with 11% of patients taking at least one drug with a known risk. Pharmacists provided specific recommendations in only eight out of 35 patients (23%) with a high-risk score and taking drugs with known risk of QT interval prolongation. Pharmacists’ recommendations, when present, were focused on drugs with known risk of QT interval prolongation, rather than patients’ additional risk factors. There is a need to improve knowledge and awareness of this topic among pharmacists performing medication reviews.

show abstract

Section: Introductionmentioning

confidence: 99%

Identification of Patients At-Risk of QT Interval Prolongation during Medication Reviews: A Missed Opportunity?

Buss

Lee

Naunton

et al. 2018

JCM

View full text Add to dashboard Cite

show abstract

Determining sensitivity and specificity of risk scores for QTc interval prolongation in hemato-oncology patients prescribed systemic antifungal therapy: a retrospective cross-sectional study

Steinbrech,

Klein,

Kirschke

et al. 2024

Int J Clin Pharm

View full text Add to dashboard Cite

Background QTc interval prolongation can result in potentially lethal arrhythmias. One risk factor is QTc-prolonging drugs, including some antifungals often used in hemato-oncology patients. Screening tools for patients at risk have not yet been investigated in this patient population. Aim Our aim was to evaluate the sensitivity and specificity of five QTc risk scores in hemato-oncology patients receiving systemic antifungal therapy. Method Data were retrieved from an internal study database including adult hemato-oncology patients prescribed systemic antifungal therapy. Data on QTc-prolonging medication, risk factors for QTc prolongation, and electrocardiograms (ECG) were collected retrospectively for a period of 12 months. The QTc risk scores according to Tisdale, Vandael, Berger, Bindraban, and Aboujaoude as well as their sensitivity and specificity were calculated. Results During the evaluated period, 77 patients were prescribed systemic antifungals resulting in 187 therapy episodes. Regarding therapy episodes, median age was 56 years (IQR 44–68), 41% (77) were female, and a median of 3 QTc-prolonging drugs were prescribed (range 0–6). ECGs were available for 45 (24%) of the therapy episodes 3–11 days after initiation of the antifungal therapy, 22 of which showed QTc prolongation. Regarding these 45 therapy episodes, sensitivity and specificity of the risk scores were calculated as follows: Tisdale 86%/22%, Vandael 91%/35%, Berger 32%/83%, Bindraban 50%/78%, Aboujaoude 14%/87%. Conclusion The QTc risk scores according to Tisdale and Vandael showed sufficient sensitivity for risk stratification in the studied patient population. In contrast, risk scores according to Berger, Bindraban, and Aboujaoude cannot be considered suitable due to poor sensitivity.

show abstract

Drug-induced torsades de pointes

Woosley

2022

Torsades De Pointes

View full text Add to dashboard Cite

QTc prolongation in acute medical admissions: an often overlooked and potentially serious finding

Cited by 3 publications

References 9 publications

Identification of Patients At-Risk of QT Interval Prolongation during Medication Reviews: A Missed Opportunity?

Identification of Patients At-Risk of QT Interval Prolongation during Medication Reviews: A Missed Opportunity?

Determining sensitivity and specificity of risk scores for QTc interval prolongation in hemato-oncology patients prescribed systemic antifungal therapy: a retrospective cross-sectional study

Drug-induced torsades de pointes

Contact Info

Product

Resources

About