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Psychotropic Polypharmacy and QT Prolonging Medications in Hospitalized Patients
Joel Moore1, Isabella Singh1, Ruby Tszwai Au1
1UniSA Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
Hospitalized patients often receive multiple psychotropic medications, increasing risks like QT prolongation. This study found concerning prescribing trends of QT-prolonging medications (QTPMs) at discharge, especially in mental health units.
Area of Science:
- Pharmacology
- Clinical Pharmacy
- Psychiatry
Background:
- Psychotropic polypharmacy is common for managing mental illnesses.
- Polypharmacy can increase adverse effects, including QT prolongation.
- QT-prolonging medications (QTPMs) require careful monitoring.
Purpose of the Study:
- To investigate prescribing trends of QTPMs in hospitalized patients.
- To compare QTPM prescribing at admission versus discharge.
- To identify patient groups at higher risk for QTPM-related adverse events.
Main Methods:
- Retrospective observational study of inpatient data (Jan-Dec 2019).
- QTPMs classified using AZCERT criteria.
- Prescribed Daily Dose (PDD) to Defined Daily Dose (DDD) ratio used for dose evaluation.
Main Results:
- Significant differences in QTPM prescribing between admission and discharge.
- Mean QTPMs decreased in acute medical and geriatric units but increased in AMHU at discharge.
- Patients in medical/geriatric units were more likely to be discharged with combined QTPMs.
Conclusions:
- Enhanced monitoring of QTPMs is crucial for hospitalized patients.
- Particular attention is needed for patients in acute mental health units.
- Age and polypharmacy are associated with high-dose QTPM prescriptions at discharge.
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