Moore Joel, Singh Isabella, Au Ruby Tszwai, Gabb Genevieve, Eng-Frost Joanne, Hotham Elizabeth, Shakib Sepehr, Suppiah Vijayaprakash
UniSA Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
Department of Cardiovascular Medicine, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Pharmacol Res Perspect. 2025 Jun;13(3):e70107. doi: 10.1002/prp2.70107.
It is common for patients with mental illnesses to be prescribed multiple psychotropic medications to effectively manage their conditions. Psychotropic polypharmacy has been shown to potentiate and increase the risks of several adverse effects, including QT prolongation. This study aimed to investigate the prescribing trends of and differences in prescribing of QT-prolonging medications (QTPMs) at admission and discharge in hospitalized patients. This retrospective observational study utilized inpatient data from three public hospitals between January and December 2019. QTPMs were classified according to the AZCERT classification. QTPMs doses were evaluated by calculating the ratio of prescribed daily dose (PDD) to the defined daily dose (DDD). Subgroup analyses showed significant differences between patient groups on admission and discharge (all p < 0.001). Mean QTPMs decreased significantly between the two time points only in patients admitted to acute medical and geriatric units (p < 0.001). PDD/DDD ratio for conditional risk QTPMs in acute mental health unit (AMHU) patients was increased at discharge (p = 0.038). Patients admitted to acute medical and geriatric units were four and eight times more likely to be discharged with one QTPM with known risk in combination with more QTPMs with conditional risk. Logistic regression showed significant relationships with age and total number of regular medicines at admission for those prescribed high-dose QTPMs at discharge. The findings underscore the necessity for enhanced monitoring of QTPMs in hospitalized patients, particularly for those at higher risk.
精神疾病患者通常会被开具多种精神药物以有效控制病情。已证明精神药物联合使用会增强并增加包括QT间期延长在内的多种不良反应的风险。本研究旨在调查住院患者入院和出院时开具QT间期延长药物（QTPMs）的处方趋势及差异。这项回顾性观察研究利用了2019年1月至12月期间三家公立医院的住院患者数据。QTPMs根据AZCERT分类进行分类。通过计算规定日剂量（PDD）与限定日剂量（DDD）的比值来评估QTPMs剂量。亚组分析显示患者组在入院和出院时存在显著差异（所有p < 0.001）。仅在入住急性内科和老年科病房的患者中，两个时间点之间的平均QTPMs显著下降（p < 0.001）。急性精神科病房（AMHU）患者出院时，有条件风险的QTPMs的PDD/DDD比值增加（p = 0.038）。入住急性内科和老年科病房的患者出院时，使用一种已知风险的QTPM与更多有条件风险的QTPMs联合使用的可能性分别是其他患者的4倍和8倍。逻辑回归显示，出院时开具高剂量QTPMs的患者，其年龄和入院时常规药物总数之间存在显著关系。研究结果强调了加强对住院患者QTPMs监测的必要性，特别是对那些高危患者。
