Prevalence and Risk Factors Associated with Use of QT-Prolonging Drugs in Hospitalized Older People

Pasquale Mansueto, Salvatore Corrao, Rossio, Luca Pasina, Carlotta Franchi, Ardoino, Pier Mannuccio Mannucci, Maura Marcucci, Pasina, Alessandra Marengoni, Biganzoli, Mauro Tettamanti, Alessandro Nobili

Risultato della ricerca: Article

15 Citazioni (Scopus)

Abstract

AIMS: The objective of this study was to evaluate the prevalence of the prescription of QT-prolonging drugs at hospital admission and discharge and the risk factors associated with their use in older people (aged 65 years and older).METHODS: Data were obtained from the REPOSI (REgistro POliterapie SIMI [Società Italiana di Medicina Interna]) registry, which enrolled 4035 patients in 2008 (n = 1332), 2010 (n = 1380), and 2012 (n = 1323). Multivariable logistic regression was performed to determine the risk factors independently associated with QT-prolonging drug use. QT-prolonging drugs were classified by the risk of Torsades de Pointes (TdP) (definite, possible, or conditional) according to the Arizona Center for Education and Research on Therapeutics (AzCERT) classification. Specific drug combinations were also assessed.RESULTS: Among 3906 patients prescribed at least one drug at admission, 2156 (55.2%) were taking at least one QT-prolonging drug. Risk factors independently associated with the use of any QT-prolonging drugs were increasing age (odds ratio [OR] 1.02, 95% CI 1.01-1.03), multimorbidity (OR 2.69, 95% CI 2.33-3.10), hypokalemia (OR 2.79, 95% CI 1.32-5.89), atrial fibrillation (OR 1.66, 95% CI 1.40-1.98), and heart failure (OR 3.17, 95% CI 2.49-4.05). Furosemide, alone or in combination, was the most prescribed drug. Amiodarone was the most prescribed drug with a definite risk of TdP. Both the absolute number of QT-prolonging drugs (2890 vs. 3549) and the number of patients treated with them (2456 vs. 2156) increased at discharge. Among 1808 patients not prescribed QT-prolonging drugs at admission, 35.8% were prescribed them at discharge.CONCLUSIONS: Despite their risk, QT-prolonging drugs are widely prescribed to hospitalized older persons. The curriculum for both practicing physicians and medical students should be strengthened to provide more education on the appropriate use of drugs in order to improve the management of hospitalized older people.
Lingua originaleEnglish
pagine (da-a)53-61
Numero di pagine9
RivistaDRUGS & AGING
Volume33
Stato di pubblicazionePublished - 2016

    Fingerprint

All Science Journal Classification (ASJC) codes

  • Geriatrics and Gerontology
  • Pharmacology (medical)

Cita questo

Mansueto, P., Corrao, S., Rossio, Pasina, L., Franchi, C., Ardoino, Mannucci, P. M., Marcucci, M., Pasina, Marengoni, A., Biganzoli, Tettamanti, M., & Nobili, A. (2016). Prevalence and Risk Factors Associated with Use of QT-Prolonging Drugs in Hospitalized Older People. DRUGS & AGING, 33, 53-61.