Media attention regarding sudden cardiac death associated with domperidone use does not affect in hospital ECG recording

• Published in: Pharmacoepidemiology and drug safety 2017-11, Vol.26 (11), p.1418-1424
• Main Authors: Berger, Florine, Saâïd, Selma, Gelder, Teun, Stricker, Bruno, Becker, Matthijs, Bemt, Patricia
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antiemetics - adverse effects; Cohort Studies; Death, Sudden, Cardiac - epidemiology; Death, Sudden, Cardiac - etiology; domperidone; Domperidone - adverse effects; Drug Prescriptions - statistics & numerical data; Drug Utilization; ECG monitoring; Echocardiography; EKG; Electrocardiography; Electrocardiography - methods; Female; Health care facilities; Heart diseases; Humans; Inpatients; Long QT Syndrome - chemically induced; Long QT Syndrome - epidemiology; Male; Mass Media; Media; media hype; Medical personnel; Middle Aged; Netherlands - epidemiology; pharmacoepidemiology; QT prolongation; regulatory warnings; Retrospective Studies; Statistical analysis; sudden cardiac death
• ISSN: 1053-8569; 1099-1557
• DOI: 10.1002/pds.4321

Purpose In March 2013, regulatory warnings concerning the potential risks of domperidone caused considerable media attention in the Netherlands. The aim of the study was to assess the effect of regulatory warnings and the resulting media hype on the frequency of electrocardiogram (ECG) monitoring of inpatients using domperidone. We also studied the effect on the frequency of prescribing domperidone by physicians. Methods A 2‐centre, observational, retrospective cohort study was performed. Inpatients using domperidone in 2 hospitals in the Netherlands during a period of 384 days before and after the media hype were included. The main outcomes were (1) the proportion of domperidone users with ECGs before and/or during domperidone treatment, (2) the proportion of patients with an ECG before and during treatment, and (3) the proportion of patients with an ECG during treatment. Secondary outcome was the proportion of domperidone prescriptions comparing the before‐ and after‐period. Results Four hundred twenty‐eight patients were included. The main outcomes [respectively (1) relative risk (RR) 1.02, 95% confidence interval (CI), 0.85‐1.21; (2) RR 1.06, 95% CI, 0.60‐1.85; and (3) RR 1.27, 95% CI, 0.80‐2.01) were not different. After stratifying for hospital, no significant differences were found. A statistically significant decrease (RR 0.40, 95% CI, 0.35‐0.45) in numbers of prescriptions was found for the university medical centre only. Conclusions No effect of the media hype was found on the intensity of ECG monitoring in domperidone users. In the university medical centre, domperidone prescriptions were reduced.