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

Lesley H. Curtis, Truls Østbye, Veronica Sendersky, Steve Hutchison, Nancy M Allen LaPointe, Sana M. Al-Khatib, Sally Usdin Yasuda, Peter E. Dans, Alan Wright, Robert M. Califf, Raymond L. Woosley, Kevin A. Schulman

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)135-141
Number of pages7
JournalAmerican Journal of Medicine
Volume114
Issue number2
DOIs
StatePublished - Feb 1 2003
Externally publishedYes

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Prescriptions
Outpatients
Pharmaceutical Preparations
Antidepressive Agents
Pharmaceutical Databases
Torsades de Pointes
Cohort Studies
Retrospective Studies
Databases
Safety

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Curtis, L. H., Østbye, T., Sendersky, V., Hutchison, S., LaPointe, N. M. A., Al-Khatib, S. M., ... Schulman, K. A. (2003). Prescription of QT-prolonging drugs in a cohort of about 5 million outpatients. American Journal of Medicine, 114(2), 135-141. https://doi.org/10.1016/S0002-9343(02)01455-9

Prescription of QT-prolonging drugs in a cohort of about 5 million outpatients. / Curtis, Lesley H.; Østbye, Truls; Sendersky, Veronica; Hutchison, Steve; LaPointe, Nancy M Allen; Al-Khatib, Sana M.; Yasuda, Sally Usdin; Dans, Peter E.; Wright, Alan; Califf, Robert M.; Woosley, Raymond L.; Schulman, Kevin A.

In: American Journal of Medicine, Vol. 114, No. 2, 01.02.2003, p. 135-141.

Research output: Contribution to journalArticle

Curtis, LH, Østbye, T, Sendersky, V, Hutchison, S, LaPointe, NMA, Al-Khatib, SM, Yasuda, SU, Dans, PE, Wright, A, Califf, RM, Woosley, RL & Schulman, KA 2003, 'Prescription of QT-prolonging drugs in a cohort of about 5 million outpatients', American Journal of Medicine, vol. 114, no. 2, pp. 135-141. https://doi.org/10.1016/S0002-9343(02)01455-9
Curtis LH, Østbye T, Sendersky V, Hutchison S, LaPointe NMA, Al-Khatib SM et al. Prescription of QT-prolonging drugs in a cohort of about 5 million outpatients. American Journal of Medicine. 2003 Feb 1;114(2):135-141. https://doi.org/10.1016/S0002-9343(02)01455-9
Curtis, Lesley H. ; Østbye, Truls ; Sendersky, Veronica ; Hutchison, Steve ; LaPointe, Nancy M Allen ; Al-Khatib, Sana M. ; Yasuda, Sally Usdin ; Dans, Peter E. ; Wright, Alan ; Califf, Robert M. ; Woosley, Raymond L. ; Schulman, Kevin A. / Prescription of QT-prolonging drugs in a cohort of about 5 million outpatients. In: American Journal of Medicine. 2003 ; Vol. 114, No. 2. pp. 135-141.
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