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Open AccessArticle

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

1
Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia
2
Department of Pharmacy Practice, Campbell University College of Pharmacy & Health Sciences, 239 J.P. Riddle Building, PO Box 1090, Buies Creek, NC 27506, USA
3
Faculty of Health, University of Tasmania, Hobart 7005, Tasmania, Australia
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(11), 1866; https://doi.org/10.3390/jcm8111866
Received: 30 September 2019 / Revised: 22 October 2019 / Accepted: 31 October 2019 / Published: 4 November 2019
(This article belongs to the Section Pharmacology)
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 residential aged care populations. The aim of this study was to investigate the prevalence of use of QT-prolonging drugs and to identify interventions made by pharmacists to reduce the risk of QT prolongation when conducting medication reviews in aged care. A retrospective analysis of 400 medication reviews undertaken by Australian pharmacists in aged care settings was conducted. The assessment included the risk of QT prolongation due to prescribed medications and other risk factors and the recommendations made by pharmacists to reduce the risk of QT prolongation. There was a high prevalence of the use of QT-prolonging medication, with 23% of residents (92 out of 400) taking at least one medication with a known risk of QT prolongation. Amongst the 945 prescribed drugs with any risk of QT prolongation, antipsychotics were the most common (n = 246, 26%), followed by antidepressants (19%) and proton pump inhibitors (13%). There appeared to be low awareness amongst 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 QT prolongation; yet pharmacists intervened in only six instances (9%), mostly when two QT-prolonging medications were prescribed. There is a need to increase awareness amongst pharmacists conducting medication reviews regarding the risk factors associated with QT prolongation, and further education is generally needed in this area. View Full-Text
Keywords: QT interval prolongation; torsade de pointes; residential aged care facilities; nursing homes; pharmacist; medication review; elderly QT interval prolongation; torsade de pointes; residential aged care facilities; nursing homes; pharmacist; medication review; elderly
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Christensen, L.; Turner, J.R.; Peterson, G.M.; Naunton, M.; Thomas, J.; Yee, K.C.; Kosari, S. Identification of Risk of QT Prolongation by Pharmacists When Conducting Medication Reviews in Residential Aged Care Settings: A Missed Opportunity? J. Clin. Med. 2019, 8, 1866.

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