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Adherence to Monitoring Guidelines of Amiodarone Adverse Reactions
Ophir Lavon1,2, Ron Goldman1
1Clinical Pharmacology and Toxicology Unit, Carmel Medical Center, Haifa, Israel.
Background:
Amiodarone treatment frequently causes adverse reactions. Clinical guidelines warrant a comprehensive assessment prior to chronic treatment with amiodarone and repeated monitoring for the appearance of adverse reactions.
Objective:
To evaluate adherence to these guidelines.
Methods:
A retrospective chart review of electronic medical records of adult patients treated with oral amiodarone for at least 12 months.
Results:
One hundred patient records were analyzed; 97% of patients were evaluated for thyroid and liver functions prior to treatment. Liver functions were properly monitored every 6 months in 96% of patients and thyroid function in only 59%. Most (84%) patients completed a chest X-ray before treatment; only 2% completed a respiratory function test. None have performed a chest X-ray annually. Sixty-four percent of the patients were examined by an ophthalmologist prior to treatment; periodic ophthalmic surveillance was not consistent. Neurological and dermatological evaluations were not recorded for any of the patients, unless symptoms appeared. Only 50% were adherent to annual cardiac reassessment.
Conclusions:
Adherence to recommended clinical guidelines for monitoring amiodarone adverse reactions is poor. Interventions to improve compliance with these guidelines are needed.
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