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Posted on 05.08.02
QT-Prolonging Drugs: Do Practitioners Know Enough About Them?
By Richeille Ricketts, MPH
When the QT interval becomes longer than normal, a potentially fatal abnormal heartbeat called "torsades de pointes," can occur. Genetic disorders, certain diseases, and some drugs can cause the QT to become prolonged. Recently, several drugs have been taken off the U.S. market because they caused QT-prolongation when used at high dosages or when given with other medicines that increased the amount of the drug in the body to dangerous levels.
The Duke CERTs conducted a pilot project to evaluate what doctors and nurses know about the QT interval and drugs that can prolong it. The purpose was to determine whether a lack of knowledge about the QT interval could explain some of the inappropriate use of these drugs in clinical practice. The results of this study were presented in March 2002 at the annual Scientific Sessions of the American College of Cardiology.
In all, 334 healthcare professionals completed a survey that was distributed at two different meetings. Most respondents were physicians, and most listed cardiology as their area of specialization. One of the most interesting results was that although most of the respondents said they would measure a QT interval before and after a patient started taking a drug that could prolong the QT interval, only 42% of them could measure the QT interval correctly on the survey. Respondents also had difficulty identifying drugs or combinations of drugs that can prolong the QT interval.
This study shows the need to improve healthcare professionals' knowledge of the QT interval and of QT-prolonging drugs. In response, the Duke CERTs has started a larger study to survey healthcare professionals around the country. With this information, they intend to develop an educational program that will be available through the Internet.
The hope is that this educational program will give healthcare professionals
essential information about the QT interval and QT-prolonging drugs, along with
an up-to-date reference site, to help them use these drugs more safely in their
practices.