{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T15:45:06Z","timestamp":1762184706449,"version":"build-2065373602"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2018,7,4]],"date-time":"2018-07-04T00:00:00Z","timestamp":1530662400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["VA IIR 14\u2013324"],"award-info":[{"award-number":["VA IIR 14\u2013324"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate national trends in electrocardiogram (EKG) monitoring in Veterans Affairs (VA) beneficiaries prescribed high\u2010dose citalopram before and after the 2011\u201312 Food and Drug Administration (FDA) safety warnings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Interrupted time\u2010series analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>National VA healthcare system data linked to Medicare data for veterans dually eligible for VA and Medicare services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Adult VA outpatients prescribed citalopram or sertraline from February 2010 to September 2013 (N=1,068,816).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>EKG monitoring for VA outpatients prescribed high\u2010dose citalopram (&gt;40 mg\/d aged \u226460, &gt;20 mg\/d aged &gt;60) or sertraline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For individuals prescribed high\u2010dose citalopram, EKG monitoring increased from 9.0% before the start of the first FDA warning to a peak of 12.6% for individuals aged 18 to 60 and from 14.0% to 19.4% for individuals aged 61 to 100. However, following the second FDA warning in 2012, EKG monitoring declined, returning to prewarning levels in both age groups. EKG monitoring did not increase in individuals with a history of previous cardiac risk factors prescribed high\u2010dose citalopram in either age group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>EKG frequency did not significantly change in individuals with cardiac risk factors at greatest potential risk for QT prolongation. Lack of responsiveness to the FDA warnings may be due to many factors, including lack of clarity about which individuals should undergo EKG monitoring, provider substitution of alternative antidepressants for citalopram, conflicting evidence regarding risk for adverse cardiac events with high\u2010dose citalopram use, and lack of provider knowledge regarding the warnings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.15420","type":"journal-article","created":{"date-parts":[[2018,7,4]],"date-time":"2018-07-04T09:01:45Z","timestamp":1530694905000},"page":"1562-1566","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Electrocardiogram Monitoring After the Food and Drug Administration Warnings for Citalopram: Unheeded Alerts?"],"prefix":"10.1111","volume":"66","author":[{"given":"Lauren B.","family":"Gerlach","sequence":"first","affiliation":[{"name":"Program for Positive Aging, Department of Psychiatry, Medical School University of Michigan Ann Arbor Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyungjin Myra","family":"Kim","sequence":"additional","affiliation":[{"name":"Center for Clinical Management Research Veterans Affairs Ann Arbor Healthcare System Ann Arbor Michigan"},{"name":"Center for Statistical Consultation and Research University of Michigan Ann Arbor Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matheos","family":"Yosef","sequence":"additional","affiliation":[{"name":"Center for Clinical Management Research Veterans Affairs Ann Arbor Healthcare System Ann Arbor Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen C.","family":"Kales","sequence":"additional","affiliation":[{"name":"Program for Positive Aging, Department of Psychiatry, Medical School University of Michigan Ann Arbor Michigan"},{"name":"Center for Clinical Management Research Veterans Affairs Ann Arbor Healthcare System Ann Arbor Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Henry","sequence":"additional","affiliation":[{"name":"Center for Clinical Management Research Veterans Affairs Ann Arbor Healthcare System Ann Arbor Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kara","family":"Zivin","sequence":"additional","affiliation":[{"name":"Program for Positive Aging, Department of Psychiatry, Medical School University of Michigan Ann Arbor Michigan"},{"name":"Center for Clinical Management Research Veterans Affairs Ann Arbor Healthcare System Ann Arbor Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,7,4]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"FDA Drug Safety Communication: Abnormal Heart Rhythms Associated with High Doses of Celexa (Citalopram Hydrobromide).2011(online). Available atwww.fda.gov\/drugs\/drugsafety\/ucm269086.htmAccessed May 18 2014."},{"key":"e_1_2_6_3_1","unstructured":"FDA Drug Safety Communication: Revised Recommendations for Celexa (Citalopram Hydrobromide) Related to a Potential Risk of Abnormal Heart Rhythms with High Doses.2012(online). Available atwww.fda.gov\/drugs\/drugsafety\/ucm297391.htmAccessed May 18 2014"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1607"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psym.2014.09.002"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2011.12.002"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2016.15111444"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.93"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2013.12030408"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f288"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.13r08672"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jagp.2016.11.010"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp130252"},{"key":"e_1_2_6_14_1","unstructured":"Department of Veterans Affairs. Updated Guidance: Citalopram Hydrobromide (Celexa) and Dose\u2010Dependent QT Interval Prolongation.2011. Available athttps:\/\/www.healthquality.va.gov\/documents\/updatenationalpbmbulletin041712final.pdfAccessed October 1 2015."},{"key":"e_1_2_6_15_1","first-page":"348","article-title":"Interrupted time series regression for the evaluation of public health interventions: a tutorial","volume":"46","author":"Lopez Bernal J","year":"2017","journal-title":"Int J Epidemiol"},{"volume-title":"Experimental and Quasi\u2010Experimental Designs for Generalized Causal Inference","year":"2001","author":"Shadish WR","key":"e_1_2_6_16_1"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.3480"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e318245a160"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1193"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004714-199910000-00004"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jagp.2017.09.024"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.publhealth.29.020907.090940"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajhp\/53.16.1953"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.287.17.2215"}],"container-title":["Journal of the American Geriatrics Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjgs.15420","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.15420","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T15:02:46Z","timestamp":1762182166000},"score":1,"resource":{"primary":{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/10.1111\/jgs.15420"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7,4]]},"references-count":23,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2018,8]]}},"alternative-id":["10.1111\/jgs.15420"],"URL":"https:\/\/doi.org\/10.1111\/jgs.15420","archive":["Portico"],"relation":{},"ISSN":["0002-8614","1532-5415"],"issn-type":[{"type":"print","value":"0002-8614"},{"type":"electronic","value":"1532-5415"}],"subject":[],"published":{"date-parts":[[2018,7,4]]},"assertion":[{"value":"2017-12-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-04-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-07-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}