Pharmacist Monitoring of QTc Interval–Prolonging Medications in Critically Ill Medical Patients: A Pilot Study

BACKGROUND:No data exist regarding the value of pharmacist monitoring of drugs associated with QTc interval prolongation.OBJECTIVE:To assess the capability, clinical impact, and economic impact of pharmacists monitoring for drug-induced QTc interval prolongation in critically ill medical adult patients.METHODS:In a prospective, parallel-group study, 149 consecutive medical intensive care unit (ICU) patients prescribed a QTc interval–prolonging drug at the Los Angeles County + University of Southern California Medical Center were assigned on alternating days to an intervention group (clinical pharmacist on physician team monitored drugs using a standardized algorithm) or a standard care group (team without pharmacist using an algorithm). The monitoring algorithm used daily assessments of electrocardiograms and laboratory data to generate pharmacotherapeutic recommendations. The primary endpoint was the frequency of QTc interval prolongation (>500 msec at any time or an increase ≥60 msec over baseline). Sec...