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Prescription of QT-prolonging drugs in a cohort of about 5 million outpatients.

Publication ,  Journal Article
Curtis, LH; Østbye, T; Sendersky, V; Hutchison, S; Allen LaPointe, NM; Al-Khatib, SM; Usdin Yasuda, S; Dans, PE; Wright, A; Califf, RM ...
Published in: Am J Med
February 1, 2003

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. 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. 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. 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.

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Published In

Am J Med

DOI

ISSN

0002-9343

Publication Date

February 1, 2003

Volume

114

Issue

2

Start / End Page

135 / 141

Location

United States

Related Subject Headings

  • United States
  • Torsades de Pointes
  • Polypharmacy
  • Outpatients
  • Ofloxacin
  • Middle Aged
  • Male
  • Humans
  • Heart Conduction System
  • General & Internal Medicine
 

Citation

APA
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ICMJE
MLA
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Curtis, L. H., Østbye, T., Sendersky, V., Hutchison, S., Allen LaPointe, N. M., Al-Khatib, S. M., … Schulman, K. A. (2003). Prescription of QT-prolonging drugs in a cohort of about 5 million outpatients. Am J Med, 114(2), 135–141. https://doi.org/10.1016/s0002-9343(02)01455-9
Curtis, Lesley H., Truls Østbye, Veronica Sendersky, Steve Hutchison, Nancy M. Allen LaPointe, Sana M. Al-Khatib, Sally Usdin Yasuda, et al. “Prescription of QT-prolonging drugs in a cohort of about 5 million outpatients.Am J Med 114, no. 2 (February 1, 2003): 135–41. https://doi.org/10.1016/s0002-9343(02)01455-9.
Curtis LH, Østbye T, Sendersky V, Hutchison S, Allen LaPointe NM, Al-Khatib SM, et al. Prescription of QT-prolonging drugs in a cohort of about 5 million outpatients. Am J Med. 2003 Feb 1;114(2):135–41.
Curtis, Lesley H., et al. “Prescription of QT-prolonging drugs in a cohort of about 5 million outpatients.Am J Med, vol. 114, no. 2, Feb. 2003, pp. 135–41. Pubmed, doi:10.1016/s0002-9343(02)01455-9.
Curtis LH, Østbye T, Sendersky V, Hutchison S, Allen LaPointe NM, Al-Khatib SM, Usdin Yasuda S, Dans PE, Wright A, Califf RM, Woosley RL, Schulman KA. Prescription of QT-prolonging drugs in a cohort of about 5 million outpatients. Am J Med. 2003 Feb 1;114(2):135–141.
Journal cover image

Published In

Am J Med

DOI

ISSN

0002-9343

Publication Date

February 1, 2003

Volume

114

Issue

2

Start / End Page

135 / 141

Location

United States

Related Subject Headings

  • United States
  • Torsades de Pointes
  • Polypharmacy
  • Outpatients
  • Ofloxacin
  • Middle Aged
  • Male
  • Humans
  • Heart Conduction System
  • General & Internal Medicine