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Rationale, development, and clinical outcomes of a multidisciplinary amiodarone clinic
C A Sanoski1, M D Schoen, R C Gonzalez
1St. John's University College of Pharmacy and Allied Health Professions, Jamaica, New York, USA.
Pharmacotherapy
|December 17, 1998
Summary
A specialized amiodarone clinic improves patient outcomes by enhancing monitoring for drug toxicities and optimizing dosage. This multidisciplinary approach ensures better adherence to guidelines for amiodarone (a medication for heart rhythm disorders).
Area of Science:
- Cardiology
- Pharmacology
- Clinical Medicine
Background:
- Amiodarone is an effective antiarrhythmic drug but carries significant risks of toxicity.
- Current guidelines recommend rigorous monitoring for amiodarone-related adverse events.
- Many patients on amiodarone are not adequately monitored according to established protocols.
Purpose of the Study:
- To outline the development and rationale of a multidisciplinary amiodarone clinic.
- To evaluate the clinical outcomes of implementing such a specialized clinic.
- To assess the impact on patient monitoring and adverse event detection.
Main Methods:
- Established a multidisciplinary clinic for ambulatory amiodarone patient follow-up.
- Collected patient data including medical history, current therapy, and baseline labs.
- Scheduled regular laboratory tests (liver, thyroid function), chest X-rays, and pulmonary function tests.
- Performed dosage adjustments as needed.
Main Results:
- 60 patients were referred to the clinic since its inception.
- Adherence to monitoring guidelines significantly increased post-referral (23% to 90%, p<0.001).
- Previously unrecognized adverse events were detected in 35% of patients, including pulmonary fibrosis and thyroid dysfunction.
- Amiodarone was discontinued in 6 patients, and dosages were adjusted in 48.4%.
Conclusions:
- Implementation of a specialized amiodarone clinic enhances patient monitoring.
- Early detection of drug-induced toxicities is improved.
- Facilitates appropriate dosage modifications, leading to better clinical outcomes.