{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T15:04:19Z","timestamp":1774364659486,"version":"3.50.1"},"reference-count":15,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,12,10]],"date-time":"2023-12-10T00:00:00Z","timestamp":1702166400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Rationale<\/jats:title><jats:p>Little is known about the prescribing of medications with potential to cause QTc\u2010prolongation in the ambulatory care settings. Understanding real\u2010world prescribing of QTc\u2010prolonging medications and actions taken to mitigate this risk will help guide strategies to optimize safety and appropriate prescribing among ambulatory patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the frequency of clinician action taken to monitor and mitigate modifiable risk factors for QTc\u2010prolongation when indicated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective, cross\u2010sectional study evaluated clinician action at the time of prescribing prespecified medications with potential to prolong QTc in adult patients in primary care. The index date was defined as the date the medication was ordered. Electronic health record (EHR) data were evaluated to assess patient, clinician\u00a0and visit characteristics. Clinician action was determined if baseline or follow\u2010up monitoring was ordered or if action was taken to mitigate modifiable risk factors (laboratory abnormalities or electrocardiogram [ECG] monitoring) within 48\u2009h of prescribing a medication with QTc\u2010prolonging risk. Descriptive statistics were used to describe current practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 399 prescriptions were prescribed to 386 patients, with a mean age of 51\u2009\u00b1\u200918 years, during March 2021 from a single\u2010centre, multisite health system. Of these, 17 (4%) patients had a known history of QTc\u2010prolongation, 170 (44%) did not have a documented history of QTc\u2010prolongation\u00a0and 199 (52%) had an unknown history (no ECG documented). Thirty\u2010nine patients (10%) had at least one laboratory\u2010related risk factor at the time of prescribing, specifically hypokalemia (16 patients), hypomagnesemia (8 patients)\u00a0or hypocalcemia (19 patients). Of these 39 patients with laboratory risk factors, only 6 patients (15%) had their risk acknowledged or addressed by a clinician. Additionally, eight patients' most recent QTc was \u2265500\u2009ms and none had an ECG checked at the time the prescription was ordered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Despite national recommendations, medication monitoring and risk mitigation is infrequent when prescribing QTc\u2010prolonging medications in the ambulatory care setting. These findings call for additional research to better understand this gap, including reasons for the gap and consequences on patient outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jep.13949","type":"journal-article","created":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T04:58:33Z","timestamp":1702270713000},"page":"385-392","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluating the prescribing and monitoring of medications associated with QTc\u2010prolongation in the ambulatory care setting"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4332-8148","authenticated-orcid":false,"given":"Rachel N.","family":"Lowe","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Garth","family":"Wright","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucas","family":"Olivas","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Candance","family":"Teel","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krithika","family":"Suresh","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Informatics Colorado School of Public Health Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura B.","family":"Macke","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Colorado School of Medicine Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amber","family":"Sieja","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Colorado School of Medicine Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A.","family":"Rosenberg","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Colorado School of Medicine Aurora Colorado USA"},{"name":"Department of Biomedical Informatics University of Colorado School of Medicine Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2041-7404","authenticated-orcid":false,"given":"Katy E.","family":"Trinkley","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences Aurora Colorado USA"},{"name":"Department of Biomedical Informatics University of Colorado School of Medicine Aurora Colorado USA"},{"name":"Department of Family Medicine University of Colorado School of Medicine Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,12,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000905"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.01.001"},{"key":"e_1_2_9_4_1","unstructured":"WoosleyRL HeiseCW GalloT WoosleyD LambsonJ RomeroK.\u00a0 QTdrugs List. 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