Computerized Tool Cuts Risk of Prolonged QTc Interval
Clinical decision support system assists with prescribing choices in hospitalized patients at risk
WEDNESDAY, May 14, 2014 (HealthDay News) -- Use of a computerized clinical decision support system (CDSS) may reduce the risk of prolonged QTc interval in hospitalized patients at risk for torsades de pointes, according to research published online May 6 in Circulation: Cardiovascular Quality and Outcomes.
James E. Tisdale, Pharm.D., of Purdue University in Indianapolis, and colleagues assessed QTc interval prolongation in patients admitted to cardiac care units before (1,200 patients) and after (1,200 patients) implementation of the CDSS. QTc interval prolongation was defined as QTc interval >500 ms or increase in QTc of ≥60 ms from baseline.
The researchers found that implementation of the CDSS was independently associated with decreased risk of QTc interval prolongation (adjusted odds ratio [aOR], 0.65; 95 percent confidence interval [CI}, 0.56 to 0.89; P < 0.0001). Use of the CDSS was also associated with decreased prescribing of noncardiac medications known to cause torsades de pointes, including fluoroquinolones and intravenous haloperidol (aOR, 0.79; 95 percent CI, 0.63 to 0.91; P = 0.03).
"A computerized CDSS incorporating a validated risk score for QTc prolongation influences the prescribing of QT-prolonging drugs and reduces the risk of QTc interval prolongation in hospitalized patients with torsades de pointes risk factors," the authors write.
Lilly Endowment Inc. funded the study. One author disclosed financial ties to Eli Lilly and other pharmaceutical companies.