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Identification of Risk of QT Prolongation by Pharmacists When Conducting Medication Reviews in Residential Aged Care Settings: A Missed Opportunity?

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Christensen, L, Turner, JR, Peterson, GM ORCID: 0000-0002-6764-3882, Naunton, M, Thomas, J, Yee, KC and Kosari, S 2019 , 'Identification of Risk of QT Prolongation by Pharmacists When Conducting Medication Reviews in Residential Aged Care Settings: A Missed Opportunity?' , Journal of Clinical Medicine, vol. 8, no. 11 , pp. 1-9 , doi: 10.3390/jcm8111866.

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Abstract

QT interval prolongation is associated with torsade de pointes and sudden cardiac death.QT prolongation can be caused by many drugs that are commonly prescribed in elderly residentialaged care populations. The aim of this study was to investigate the prevalence of use of QT-prolongingdrugs and to identify interventions made by pharmacists to reduce the risk of QT prolongationwhen conducting medication reviews in aged care. A retrospective analysis of 400 medicationreviews undertaken by Australian pharmacists in aged care settings was conducted. The assessmentincluded the risk of QT prolongation due to prescribed medications and other risk factors and therecommendations made by pharmacists to reduce the risk of QT prolongation. There was a highprevalence of the use of QT-prolonging medication, with 23% of residents (92 out of 400) takingat least one medication with a known risk of QT prolongation. Amongst the 945 prescribed drugswith any risk of QT prolongation, antipsychotics were the most common (n = 246, 26%), followedby antidepressants (19%) and proton pump inhibitors (13%). There appeared to be low awarenessamongst the pharmacists regarding the risk of QT prolongation with drugs. Out of 400 reviews,66 residents were categorised as high risk and were taking at least one medication associated with QTprolongation; yet pharmacists intervened in only six instances (9%), mostly when two QT-prolongingmedications were prescribed. There is a need to increase awareness amongst pharmacists conductingmedication reviews regarding the risk factors associated with QT prolongation, and further educationis generally needed in this area.

Item Type: Article
Authors/Creators:Christensen, L and Turner, JR and Peterson, GM and Naunton, M and Thomas, J and Yee, KC and Kosari, S
Keywords: QT interval prolongation; torsade de pointes; residential aged care facilities; nursing homes; pharmacist; medication review; elderly
Journal or Publication Title: Journal of Clinical Medicine
Publisher: M D P I AG
ISSN: 2077-0383
DOI / ID Number: 10.3390/jcm8111866
Copyright Information:

Copyright 2019 The Authors. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0) https://creativecommons.org/licenses/by/4.0/

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