Key result
Clinical pharmacist interventions are linked to QTc normalization in ~64% of patients with prolongation.
Why the study?
Drug-induced QTc prolongation is the predominant cause of acquired long QTc syndrome, and the role of clinical pharmacists in reducing this condition and its progression toward life-threatening arrhythmias needed evaluation.
Does clinical pharmacist intervention reduce drug-induced QTc prolongation in hospitalized at-risk patients?
Cross-Sectional (n=90)
No
Does clinical pharmacist intervention reduce drug-induced QTc prolongation in hospitalized at-risk patients?
Clinical pharmacist interventions using risk scoring can achieve high physician acceptance and effectively normalize QTc intervals in high-risk hospitalized patients.
May support pharmacist QTc monitoring; hypothesis-generating and requires RCTs before practice change.
Background: Drug-induced QTc prolongation represents the predominant cause of acquired long QTc syndrome. Pharmacists’ intervention, through the screening of at-risk patients and the provision of recommendations to prescribers for modifying drug regimens, may mitigate the adverse outcomes associated with this condition. This cross-sectional study aimed to evaluate the role of clinical pharmacists in reducing drug-induced acquired long QTc syndrome and mitigating the risk of progression toward life-threatening arrhythmias. Methods: We included hospitalized patients who were receiving at least two concomitant QT-prolonging medications, or one QT-prolonging medication along with a diagnosis of heart failure, myocardial infarction, or sepsis in the study over three months. Using the Tisdale risk score, we provided recommendations to the prescribing physician, and acceptance rates were recorded. Additionally, the rate of QTc prolongation was assessed in the patients. Results: The study was completed with 90 patients. The concomitant use of ondansetron and methadone was identified as the most common high-risk drug combination. A total of 56 pharmacist recommendations were made, with an estimated physician acceptance rate of 89%. Additionally, normalization of the QTc interval was observed in 14 out of 22 patients (63.6%) following pharmacists’ intervention. Conclusion: Clinical pharmacists are instrumental in the prevention of drug-induced long QTc syndrome among hospitalized patients.
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Pirsalehi et al. (2025) conducted a cross-sectional in Drug-induced QTc prolongation risk (n=90). Clinical pharmacist recommendations was evaluated on Normalization of QTc interval in patients with observed prolongation. Clinical pharmacist interventions achieved an 89% physician acceptance rate and resulted in the normalization of the QTc interval in 63.6% of patients with observed prolongation.
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