The Role of Clinical Pharmacists in Mitigating Drug-Induced QTc Prolongation: A Cross-Sectional Study

Abstract

Background: Drug-induced QTc prolongation represents the predominant cause of acquired long QTc syndrome. Pharmacists’ intervention, through the screening of at-risk patients and the provision of recommendations to prescribers for modifying drug regimens, may mitigate the adverse outcomes associated with this condition. This cross-sectional study aimed to evaluate the role of clinical pharmacists in reducing drug-induced acquired long QTc syndrome and mitigating the risk of progression toward life-threatening arrhythmias.

Methods: We included hospitalized patients who were receiving at least two concomitant QT-prolonging medications, or one QT-prolonging medication along with a diagnosis of heart failure, myocardial infarction, or sepsis in the study over three months. Using the Tisdale risk score, we provided recommendations to the prescribing physician, and acceptance rates were recorded. Additionally, the rate of QTc prolongation was assessed in the patients.

Results: The study was completed with 90 patients. The concomitant use of ondansetron and methadone was identified as the most common high-risk drug combination. A total of 56 pharmacist recommendations were made, with an estimated physician acceptance rate of 89%. Additionally, normalization of the QTc interval was observed in 14 out of 22 patients (63.6%) following pharmacists’ intervention.

Conclusion: Clinical pharmacists are instrumental in the prevention of drug-induced long QTc syndrome among hospitalized patients.