Following a 2012 Health Canada warning, domperidone prescriptions for nonapproved indications decreased from 84.8% in 2005 to 58.2% in 2012 (p<0.0001).
Observational (n=577)
No
Did the 2012 Health Canada advisory improve the appropriateness of domperidone prescribing practices and reduce cardiac risk exposure?
The Health Canada advisory was associated with a significant decrease in inappropriate domperidone prescribing, though nonapproved indications remained common.
Absolute Event Rate: 58.2% vs 84.8%
p-value: p=<0.0001
Background. In 2012, Health Canada released a warning regarding domperidone use, based on associations with life-threatening arrhythmias and death. Objective. This study aimed to compare the appropriateness of domperidone prescribing patterns before the advisory to those afterward. Methods. Two retrospective reviews were conducted for patients prescribed domperidone during quarters in 2005 and 2012. Outcomes included appropriateness of indication, dosing regimens, monitoring of electrolytes, baseline electrocardiogram performance and characteristics, presence of left ventricular dysfunction, and coprescription of QT-prolonging medications. Univariable and multivariable logistic regression analyses were performed. p values < 0.05 were considered significant. Results. 290 and 287 patients were analyzed in 2005 and 2012, respectively. Domperidone initiation in hospital decreased from 2005 to 2012 (71.4% versus 39.4%, p < 0.0001) as did prescriptions for nonapproved indications (84.8% versus 58.2%, p < 0.0001). In-hospital initiation predicted prescription for nonapproved indications (OR = 7.01, 95% CI 4.52-10.87, p < 0.0001). Use of domperidone as the sole GI drug predicted nonapproved indications (OR = 2.51, 95% CI 1.38-4.55, p = 0.002). Conclusions. The advisory was associated with more appropriate domperidone initiation and compliance with recommended dosages. Our study suggests the need for increased awareness of the dosing and monitoring of domperidone to ensure patient safety.
Forbes et al. (Fri,) conducted a observational in Patients prescribed domperidone (n=577). Health Canada warning advisory on domperidone vs. Prescribing patterns before the advisory (2005) was evaluated on Prescriptions for nonapproved indications (p=<0.0001). Following a 2012 Health Canada warning, domperidone prescriptions for nonapproved indications decreased from 84.8% in 2005 to 58.2% in 2012 (p<0.0001).