Impact of Pharmacist Intervention on Electrocardiogram Monitoring of Pediatric Patients on Multiple QTc Interval–Prolonging Medications

OBJECTIVES To determine whether dedicated pharmacy services improve the rate of electrocardiogram (ECG) monitoring in patients at risk for medication-induced QTc interval prolongation. In addition, determine how pediatric institutions currently monitor patients at risk for medication-induced QTc interval prolongation. METHODS A pharmacist-driven monitoring protocol to detect medication-induced QTc interval prolongation was developed using published literature. If patients were prescribed 3 or more medications known to prolong the QTc interval, they were recommended to have a baseline ECG to assess the QTc interval. If 3 or more QTc interval–prolonging medications were administered for 5 or more days, a follow-up ECG was recommended. Patients prescribed medications known to prolong the QTc interval were identified. Prior to pharmacist intervention, electronic medical records were reviewed to determine if baseline and follow-up ECGs were obtained in patients meeting criteria for monitoring. A dedicated phar...