Medication safety in a pandemic: A multicentre point prevalence study of QTc monitoring of hydroxychloroquine for COVID-19.
Identifieur interne : 000043 ( Main/Corpus ); précédent : 000042; suivant : 000044Medication safety in a pandemic: A multicentre point prevalence study of QTc monitoring of hydroxychloroquine for COVID-19.
Auteurs : Steven M. Smoke ; Henry Leach ; Nicole Leonida ; Karan Raja ; Monica Shah ; Vishal Patel ; Gargi Patel ; Nicole M. Daniel ; Jessica Gerges ; Akshar PatelSource :
- Journal of clinical pharmacy and therapeutics [ 1365-2710 ] ; 2021.
Abstract
WHAT IS KNOWN AND OBJECTIVE
A pandemic can strain all aspects of the healthcare system, including the ability to monitor the safety of medication use. Reviewing the adequacy of medication safety practices during the COVID-19 pandemic is critical to informing responses to future pandemics. The purpose of this study was to evaluate medication safety practices at a height of both COVID-19 cases and hydroxychloroquine use.
METHODS
This was a multicentre observational point prevalence study. Adult inpatients receiving hydroxychloroquine for COVID-19 between March 22 and 28, 2020 were included. The primary outcome was the percentage of patients receiving appropriate QTc monitoring. Secondary outcomes included QTc prolongation, early discontinuation of hydroxychloroquine and ventricular arrhythmias.
RESULTS AND DISCUSSION
A total of 59% (167/284) of patients treated with hydroxychloroquine received appropriate QTc monitoring. QTc prolongation occurred in 25%. Hydroxychloroquine was prematurely discontinued in 1.4% of patients, all due to QTc prolongation. Ventricular arrhythmia occurred in 1.1%.
WHAT IS NEW AND CONCLUSION
Medication safety practices were suboptimal with regard to hydroxychloroquine monitoring at the height of the COVID-19 pandemic. Preparation for future pandemics should devote considerable attention to medication safety.
DOI: 10.1111/jcpt.13429
PubMed: 33959987
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Smoke</name><affiliation><nlm:affiliation>Pharmacy Department, Saint Barnabas Medical Center, Livingston, NJ, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Leach, Henry" sort="Leach, Henry" uniqKey="Leach H" first="Henry" last="Leach">Henry Leach</name><affiliation><nlm:affiliation>Pharmacy Department, Barnabas Health Behavioral Health Center, Toms River, NJ, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Leonida, Nicole" sort="Leonida, Nicole" uniqKey="Leonida N" first="Nicole" last="Leonida">Nicole Leonida</name><affiliation><nlm:affiliation>Pharmacy Department, Jersey City Medical Center, Jersey City, NJ, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Raja, Karan" sort="Raja, Karan" uniqKey="Raja K" first="Karan" last="Raja">Karan Raja</name><affiliation><nlm:affiliation>Pharmacy Department, Clara Maass Medical Center, Belleville, NJ, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Shah, Monica" sort="Shah, Monica" uniqKey="Shah M" first="Monica" last="Shah">Monica Shah</name><affiliation><nlm:affiliation>Pharmacy Department, Monmouth Medical Center, Long Branch, NJ, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Patel, Vishal" sort="Patel, Vishal" uniqKey="Patel V" first="Vishal" last="Patel">Vishal Patel</name><affiliation><nlm:affiliation>Idaho College of Osteopathic Medicine, Meridian, ID, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Patel, Gargi" sort="Patel, Gargi" uniqKey="Patel G" first="Gargi" last="Patel">Gargi Patel</name><affiliation><nlm:affiliation>Pharmacy Department, Community Medical Center, Toms River, NJ, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Daniel, Nicole M" sort="Daniel, Nicole M" uniqKey="Daniel N" first="Nicole M" last="Daniel">Nicole M. Daniel</name><affiliation><nlm:affiliation>Pharmacy Department, Clara Maass Medical Center, Belleville, NJ, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Gerges, Jessica" sort="Gerges, Jessica" uniqKey="Gerges J" first="Jessica" last="Gerges">Jessica Gerges</name><affiliation><nlm:affiliation>Pharmacy Department, Clara Maass Medical Center, Belleville, NJ, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Patel, Akshar" sort="Patel, Akshar" uniqKey="Patel A" first="Akshar" last="Patel">Akshar Patel</name><affiliation><nlm:affiliation>Pharmacy Department, Saint Barnabas Medical Center, Livingston, NJ, USA.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2021">2021</date><idno type="RBID">pubmed:33959987</idno><idno type="pmid">33959987</idno><idno type="doi">10.1111/jcpt.13429</idno><idno type="wicri:Area/Main/Corpus">000043</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000043</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Medication safety in a pandemic: A multicentre point prevalence study of QTc monitoring of hydroxychloroquine for COVID-19.</title><author><name sortKey="Smoke, Steven M" sort="Smoke, Steven M" uniqKey="Smoke S" first="Steven M" last="Smoke">Steven M. Smoke</name><affiliation><nlm:affiliation>Pharmacy Department, Saint Barnabas Medical Center, Livingston, NJ, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Leach, Henry" sort="Leach, Henry" uniqKey="Leach H" first="Henry" last="Leach">Henry Leach</name><affiliation><nlm:affiliation>Pharmacy Department, Barnabas Health Behavioral Health Center, Toms River, NJ, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Leonida, Nicole" sort="Leonida, Nicole" uniqKey="Leonida N" first="Nicole" last="Leonida">Nicole Leonida</name><affiliation><nlm:affiliation>Pharmacy Department, Jersey City Medical Center, Jersey City, NJ, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Raja, Karan" sort="Raja, Karan" uniqKey="Raja K" first="Karan" last="Raja">Karan Raja</name><affiliation><nlm:affiliation>Pharmacy Department, Clara Maass Medical Center, Belleville, NJ, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Shah, Monica" sort="Shah, Monica" uniqKey="Shah M" first="Monica" last="Shah">Monica Shah</name><affiliation><nlm:affiliation>Pharmacy Department, Monmouth Medical Center, Long Branch, NJ, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Patel, Vishal" sort="Patel, Vishal" uniqKey="Patel V" first="Vishal" last="Patel">Vishal Patel</name><affiliation><nlm:affiliation>Idaho College of Osteopathic Medicine, Meridian, ID, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Patel, Gargi" sort="Patel, Gargi" uniqKey="Patel G" first="Gargi" last="Patel">Gargi Patel</name><affiliation><nlm:affiliation>Pharmacy Department, Community Medical Center, Toms River, NJ, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Daniel, Nicole M" sort="Daniel, Nicole M" uniqKey="Daniel N" first="Nicole M" last="Daniel">Nicole M. Daniel</name><affiliation><nlm:affiliation>Pharmacy Department, Clara Maass Medical Center, Belleville, NJ, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Gerges, Jessica" sort="Gerges, Jessica" uniqKey="Gerges J" first="Jessica" last="Gerges">Jessica Gerges</name><affiliation><nlm:affiliation>Pharmacy Department, Clara Maass Medical Center, Belleville, NJ, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Patel, Akshar" sort="Patel, Akshar" uniqKey="Patel A" first="Akshar" last="Patel">Akshar Patel</name><affiliation><nlm:affiliation>Pharmacy Department, Saint Barnabas Medical Center, Livingston, NJ, USA.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Journal of clinical pharmacy and therapeutics</title><idno type="eISSN">1365-2710</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>WHAT IS KNOWN AND OBJECTIVE</b></p><p>A pandemic can strain all aspects of the healthcare system, including the ability to monitor the safety of medication use. Reviewing the adequacy of medication safety practices during the COVID-19 pandemic is critical to informing responses to future pandemics. The purpose of this study was to evaluate medication safety practices at a height of both COVID-19 cases and hydroxychloroquine use.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>This was a multicentre observational point prevalence study. Adult inpatients receiving hydroxychloroquine for COVID-19 between March 22 and 28, 2020 were included. The primary outcome was the percentage of patients receiving appropriate QTc monitoring. Secondary outcomes included QTc prolongation, early discontinuation of hydroxychloroquine and ventricular arrhythmias.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS AND DISCUSSION</b></p><p>A total of 59% (167/284) of patients treated with hydroxychloroquine received appropriate QTc monitoring. QTc prolongation occurred in 25%. Hydroxychloroquine was prematurely discontinued in 1.4% of patients, all due to QTc prolongation. Ventricular arrhythmia occurred in 1.1%.</p></div><div type="abstract" xml:lang="en"><p><b>WHAT IS NEW AND CONCLUSION</b></p><p>Medication safety practices were suboptimal with regard to hydroxychloroquine monitoring at the height of the COVID-19 pandemic. Preparation for future pandemics should devote considerable attention to medication safety.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">33959987</PMID><DateRevised><Year>2021</Year><Month>05</Month><Day>07</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1365-2710</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2021</Year><Month>May</Month><Day>06</Day></PubDate></JournalIssue><Title>Journal of clinical pharmacy and therapeutics</Title><ISOAbbreviation>J Clin Pharm Ther</ISOAbbreviation></Journal><ArticleTitle>Medication safety in a pandemic: A multicentre point prevalence study of QTc monitoring of hydroxychloroquine for COVID-19.</ArticleTitle><ELocationID EIdType="doi" ValidYN="Y">10.1111/jcpt.13429</ELocationID><Abstract><AbstractText Label="WHAT IS KNOWN AND OBJECTIVE" NlmCategory="OBJECTIVE">A pandemic can strain all aspects of the healthcare system, including the ability to monitor the safety of medication use. Reviewing the adequacy of medication safety practices during the COVID-19 pandemic is critical to informing responses to future pandemics. The purpose of this study was to evaluate medication safety practices at a height of both COVID-19 cases and hydroxychloroquine use.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">This was a multicentre observational point prevalence study. Adult inpatients receiving hydroxychloroquine for COVID-19 between March 22 and 28, 2020 were included. The primary outcome was the percentage of patients receiving appropriate QTc monitoring. Secondary outcomes included QTc prolongation, early discontinuation of hydroxychloroquine and ventricular arrhythmias.</AbstractText><AbstractText Label="RESULTS AND DISCUSSION" NlmCategory="CONCLUSIONS">A total of 59% (167/284) of patients treated with hydroxychloroquine received appropriate QTc monitoring. QTc prolongation occurred in 25%. Hydroxychloroquine was prematurely discontinued in 1.4% of patients, all due to QTc prolongation. Ventricular arrhythmia occurred in 1.1%.</AbstractText><AbstractText Label="WHAT IS NEW AND CONCLUSION" NlmCategory="CONCLUSIONS">Medication safety practices were suboptimal with regard to hydroxychloroquine monitoring at the height of the COVID-19 pandemic. Preparation for future pandemics should devote considerable attention to medication safety.</AbstractText><CopyrightInformation>© 2021 John Wiley & Sons Ltd.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Smoke</LastName><ForeName>Steven M</ForeName><Initials>SM</Initials><Identifier Source="ORCID">https://orcid.org/0000-0003-4847-3432</Identifier><AffiliationInfo><Affiliation>Pharmacy Department, Saint Barnabas Medical Center, Livingston, NJ, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Leach</LastName><ForeName>Henry</ForeName><Initials>H</Initials><Identifier Source="ORCID">https://orcid.org/0000-0003-1142-9868</Identifier><AffiliationInfo><Affiliation>Pharmacy Department, Barnabas Health Behavioral Health Center, Toms River, NJ, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Leonida</LastName><ForeName>Nicole</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Pharmacy Department, Jersey City Medical Center, Jersey City, NJ, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Raja</LastName><ForeName>Karan</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Pharmacy Department, Clara Maass Medical Center, Belleville, NJ, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Shah</LastName><ForeName>Monica</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Pharmacy Department, Monmouth Medical Center, Long Branch, NJ, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Patel</LastName><ForeName>Vishal</ForeName><Initials>V</Initials><Identifier Source="ORCID">https://orcid.org/0000-0002-0886-5063</Identifier><AffiliationInfo><Affiliation>Idaho College of Osteopathic Medicine, Meridian, ID, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Patel</LastName><ForeName>Gargi</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Pharmacy Department, Community Medical Center, Toms River, NJ, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Daniel</LastName><ForeName>Nicole M</ForeName><Initials>NM</Initials><AffiliationInfo><Affiliation>Pharmacy Department, Clara Maass Medical Center, Belleville, NJ, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gerges</LastName><ForeName>Jessica</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Pharmacy Department, Clara Maass Medical Center, Belleville, NJ, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Patel</LastName><ForeName>Akshar</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Pharmacy Department, Saint Barnabas Medical Center, Livingston, NJ, USA.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>05</Month><Day>06</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>J Clin Pharm Ther</MedlineTA><NlmUniqueID>8704308</NlmUniqueID><ISSNLinking>0269-4727</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Covid-19</Keyword><Keyword MajorTopicYN="N">drug monitoring</Keyword><Keyword MajorTopicYN="N">hydroxychloroquine</Keyword><Keyword MajorTopicYN="N">medication safety</Keyword><Keyword MajorTopicYN="N">pandemic</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2021</Year><Month>02</Month><Day>25</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2021</Year><Month>04</Month><Day>13</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>5</Month><Day>7</Day><Hour>7</Hour><Minute>30</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>5</Month><Day>8</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>5</Month><Day>8</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33959987</ArticleId><ArticleId IdType="doi">10.1111/jcpt.13429</ArticleId></ArticleIdList><ReferenceList><Title>REFERENCES</Title><Reference><Citation>World Health Organization. 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