— Most scripts stemmed from clinicians besides nephrologists
by Kristen Monaco, Senior Staff Writer, MedPage Today
April 30, 2024
Non-nephrologists regularly recommended QT-prolonging medications with recognized torsades de pointes (TdP) threat to older dialysis-dependent clients, and typically these prescriptions originated from nonacute settings, a cross-sectional research study recommended.
Amongst Medicare clients with kidney failure getting in-center hemodialysis, 52.9% filled an outpatient prescription for among the 7 most often filled QT-prolonging medications with recognized TdP danger, Jennifer Flythe, MD, MPH, of the University of North Carolina Kidney Center in Chapel Hill, and coworkers reported.
The bulk (78.6% to 93.9%) of QT-prolonging medication prescriptions with recognized TdP threat happened beyond an intense care occasion, and less than 25% happened within 1 week of a severe care encounter, they composed in JAMA Network OpenThe majority of prescriptions (80.2%) stemmed from non-nephrologists.
“We were amazed that a lot of the possibly dangerous medications were recommended in the outpatient setting by non-nephrology clinicians,” Flythe informed MedPage Today“This finding assists us understand where and to whom to target interventions.”
These clients currently had greater threats for drug-related damages due to transformed drug metabolic process than the basic population and usually had various comorbid conditions handled by several clinicians and prescription medications, Flythe mentioned. QT-prolonging medications with recognized TdP threat have actually been related to greater danger of unexpected heart death, which is a leading reason for death in hemodialysis clients.
Clinicians must carry out medication reconciliation regularly and look carefully for sets of possibly communicating medications, co-author Virginia Wang, PhD, of Duke University School of Medicine in Durham, North Carolina, recommended.
“At the health system [level]there are lots of chances to much better coordinate care and avoid r