High prevalence of risk factors in elderly patients using drugs associated with acquired torsades de pointes chronically in Colombia

• Published in: British journal of clinical pharmacology 2016-08, Vol.82 (2), p.504-511
• Main Authors: Moreno‐Gutiérrez, Paula Andrea, Gaviria‐Mendoza, Andrés, Cañón, Mauricio Montoya, Machado‐Alba, Jorge Enrique
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Colombia; Colombia - epidemiology; Dose-Response Relationship, Drug; Drug-Related Side Effects and Adverse Reactions - epidemiology; drug‐related side effects and adverse reactions; Female; Humans; long QT syndrome; Long QT Syndrome - chemically induced; Long QT Syndrome - epidemiology; Long QT Syndrome - etiology; Male; Pharmacoepidemiology; pharmacovigilance; Polypharmacy; Prevalence; Risk Factors; torsades de pointes; Torsades de Pointes - chemically induced; Torsades de Pointes - epidemiology; Torsades de Pointes - etiology
• ISSN: 0306-5251; 1365-2125
• DOI: 10.1111/bcp.12969

Aims Medication is one of the main causes of long QT syndrome (LQTS) and torsades de pointes (TdP), and the older adult population is at particularly high risk. The aim of the present study was to describe the prescription patterns of drugs with a risk of TdP in the Colombian older adult population. Methods Patients older than 65 years who received medication with a risk of TdP during three consecutive months were selected. The medication was obtained and classified according to the QT Drug List from Crediblemeds.org. The data were analysed using SPSS‐22. Results A total of 55 932 patients were chronically receiving QT‐prolonging drugs; 61.9% (n = 34 ,632) were women and the mean age of the sample was 75.6 years. Drugs with a conditional risk were consumed by 95.2% of patients, 5.3% received drugs with a known risk and 2.9% received drugs with a possible risk. Two or more QT‐prolonging drugs were consumed by 10.3% of the patients (n = 5786). Most of the sample (96.8%, n = 54 170) had at least one additional risk factor for LQTS, with a mean of 3.1 ± 0.9 risk factors. Patients receiving QT‐prolonging drugs for psychiatric and neurological disease were at a higher risk of major polypharmacy [odds ratio (OR) 3.0; 95% confidence interval (CI) 2.80, 3.22) and of receiving high doses of QT‐prolonging drugs (OR 3.8; 95% CI 3.52, 4.05). Conclusions The widespread use of medication that causes TdP and the high prevalence of additional risks in the older adult population raise the need for accurate prediction of risk and constant patient monitoring. Patients taking psychiatric drugs are at a higher risk of TdP.