Christensen Louise, Turner J Rick, Peterson Gregory M, Naunton Mark, Thomas Jackson, Yee Kwang Choon, Kosari Sam
Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia.
Department of Pharmacy Practice, Campbell University College of Pharmacy & Health Sciences, 239 J.P. Riddle Building, PO Box 1090, Buies Creek, NC 27506, USA.
J Clin Med. 2019 Nov 4;8(11):1866. doi: 10.3390/jcm8111866.
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 ( = 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.
QT间期延长与尖端扭转型室速及心源性猝死相关。QT间期延长可由许多在老年居住型养老机构人群中常用的药物引起。本研究的目的是调查延长QT间期药物的使用情况，并确定药剂师在老年护理机构进行药物审查时为降低QT间期延长风险所采取的干预措施。对澳大利亚药剂师在老年护理机构进行的400次药物审查进行了回顾性分析。评估内容包括因处方药物及其他风险因素导致QT间期延长的风险，以及药剂师为降低QT间期延长风险所提出的建议。延长QT间期药物的使用普遍存在，23%的居民（400人中的92人）至少服用一种已知有延长QT间期风险的药物。在945种有任何延长QT间期风险的处方药中，抗精神病药物最为常见（246种，占26%），其次是抗抑郁药（19%）和质子泵抑制剂（13%）。药剂师对药物导致QT间期延长的风险似乎认识不足。在400次审查中，66名居民被归类为高风险，且至少服用一种与QT间期延长相关的药物；然而，药剂师仅在6例（9%）中进行了干预，大多是在开出两种延长QT间期的药物时。有必要提高进行药物审查的药剂师对与QT间期延长相关风险因素的认识，并且该领域通常需要进一步的教育。
