Prescription of QT-prolonging drugs in a cohort of about 5 million outpatients
| Autor: | Steve Hutchison, Raymond L. Woosley, Kevin A. Schulman, Sana M. Al-Khatib, Veronica Sendersky, Truls Østbye, Nancy M. Allen LaPointe, Peter E. Dans, Alan Wright, Sally Usdin Yasuda, Robert M. Califf, Lesley H. Curtis |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Adult
Male Drug Ofloxacin medicine.medical_specialty Heart disease Amitriptyline media_common.quotation_subject Antidepressive Agents Tricyclic Drug Prescriptions QT interval Cohort Studies Anti-Infective Agents Heart Conduction System Torsades de Pointes Clarithromycin Fluoxetine Internal medicine Outpatients medicine Humans Medical prescription Aged media_common Antibacterial agent business.industry Drug Synergism Retrospective cohort study General Medicine Middle Aged medicine.disease United States Anti-Bacterial Agents Erythromycin Surgery Cohort Polypharmacy Antidepressive Agents Second-Generation Female business Cohort study |
| Zdroj: | The American Journal of Medicine. 114:135-141 |
| ISSN: | 0002-9343 |
| DOI: | 10.1016/s0002-9343(02)01455-9 |
| Popis: | Purpose Many drugs prolong the QT interval and increase the risk of torsade de pointes. Concurrent use of two or more of these drugs can further increase the risk, but the prevalence of concurrent prescription of QT-prolonging drugs is not known. Methods Using the administrative claims database of a national pharmaceutical benefit manager, we conducted a retrospective cohort study in 4,825,345 subjects aged 18 years or older. After identifying 50 drugs with QT-prolonging potential, and an additional 26 drugs that inhibit the metabolic clearance of QT-prolonging drugs, we measured the frequency of overlapping prescriptions for two or more of these drugs in the outpatient setting in 1999. Results Nearly 1.1 million subjects (22.8%) filled 4.4 million prescriptions for QT-prolonging drugs. Of these, 103,119 subjects (9.4%) filled overlapping prescriptions for two or more of the drugs or for a QT-prolonging drug and another drug that inhibits its clearance; 7249 subjects (0.7%) filled overlapping prescriptions for three or more of these drugs. Twenty-two percent of subjects who filled overlapping prescriptions were aged 65 or older; 74% were women. Antidepressants were involved in nearly 50% of the cases. Conclusion Concurrent prescription of QT-prolonging drugs is common in the outpatient setting, and antidepressants are involved in half of these cases. Large pharmaceutical claims databases are useful for detecting potentially harmful prescribing behaviors, but better clinical evidence on medication safety is needed before such a system can be implemented fully. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|