Key result
Among 305 UK memory clinic practitioners, 84% completed a pulse and cardiac history before prescribing acetylcholinesterase inhibitors, but only 34% routinely conducted an electrocardiogram on all patients.
Why the study?
Acetylcholinesterase inhibitors can cause cardiac side effects, but there is little consensus on when or how electrocardiograms should be obtained before treatment, potentially leading to inconsistent practice and patient safety concerns.
Cross-Sectional (n=305)
Yes
Answers are grounded in this paper and cite their sources.
There is significant variation in cardiac monitoring practices before prescribing acetylcholinesterase inhibitors in UK memory clinics, highlighting the need for national guidelines to standardize care and ensure patient safety.
AIMS AND METHOD: People diagnosed with dementia are often started on acetylcholinesterase inhibitors (AChEIs). As AChEIs can be associated with cardiac side-effects, an electrocardiogram (ECG) is sometimes requested before treatment. Previous work has suggested there is little consensus as to when or how ECGs should be obtained. This can create inconsistent practice, with patient safety, economic and practical repercussions. We surveyed 305 UK memory clinic practitioners about prescribing practice. RESULTS: More than 84% of respondents completed a pulse and cardiac history before prescribing AChEIs. Opinion was divided as to who should fund and conduct ECGs. It was believed that obtaining an ECG causes patients inconvenience and delays treatment. Despite regularly interpreting ECGs, 76% of respondents did not update this clinical skill regularly. CLINICAL IMPLICATIONS: The variation in practice observed has service-level and patient implications and raises potential patient safety concerns. Implementing national guidelines or seeking novel ways of conducting cardiac monitoring could help standardise practice.
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Crowther et al. (2021) conducted a cross-sectional in Dementia (n=305). Cardiac monitoring practices was evaluated on Proportion of practitioners conducting an electrocardiogram (ECG) on every patient before prescribing acetylcholinesterase inhibitors. Among 305 UK memory clinic practitioners, 84% completed a pulse and cardiac history before prescribing acetylcholinesterase inhibitors, but only 34% routinely conducted an electrocardiogram on all patients.
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