Psychotropic Polypharmacy and QT Prolonging Medications in Hospitalized Patients
ABSTRACT It is common for patients with mental illnesses to be prescribed multiple psychotropic medications to effectively manage their conditions. Psychotropic polypharmacy has been shown to potentiate and increase the risks of several adverse effects, including QT prolongation. This study aimed to...
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| Format: | Article |
| Language: | English |
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Wiley
2025-06-01
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| Series: | Pharmacology Research & Perspectives |
| Online Access: | https://doi.org/10.1002/prp2.70107 |
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| author | Joel Moore Isabella Singh Ruby Tszwai Au Genevieve Gabb Joanne Eng‐Frost Elizabeth Hotham Sepehr Shakib Vijayaprakash Suppiah |
| author_facet | Joel Moore Isabella Singh Ruby Tszwai Au Genevieve Gabb Joanne Eng‐Frost Elizabeth Hotham Sepehr Shakib Vijayaprakash Suppiah |
| author_sort | Joel Moore |
| collection | DOAJ |
| description | ABSTRACT It is common for patients with mental illnesses to be prescribed multiple psychotropic medications to effectively manage their conditions. Psychotropic polypharmacy has been shown to potentiate and increase the risks of several adverse effects, including QT prolongation. This study aimed to investigate the prescribing trends of and differences in prescribing of QT‐prolonging medications (QTPMs) at admission and discharge in hospitalized patients. This retrospective observational study utilized inpatient data from three public hospitals between January and December 2019. QTPMs were classified according to the AZCERT classification. QTPMs doses were evaluated by calculating the ratio of prescribed daily dose (PDD) to the defined daily dose (DDD). Subgroup analyses showed significant differences between patient groups on admission and discharge (all p < 0.001). Mean QTPMs decreased significantly between the two time points only in patients admitted to acute medical and geriatric units (p < 0.001). PDD/DDD ratio for conditional risk QTPMs in acute mental health unit (AMHU) patients was increased at discharge (p = 0.038). Patients admitted to acute medical and geriatric units were four and eight times more likely to be discharged with one QTPM with known risk in combination with more QTPMs with conditional risk. Logistic regression showed significant relationships with age and total number of regular medicines at admission for those prescribed high‐dose QTPMs at discharge. The findings underscore the necessity for enhanced monitoring of QTPMs in hospitalized patients, particularly for those at higher risk. |
| format | Article |
| id | doaj-art-6fdd5109a25d4a6187fda4f2bbf9aefa |
| institution | DOAJ |
| issn | 2052-1707 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Pharmacology Research & Perspectives |
| spelling | doaj-art-6fdd5109a25d4a6187fda4f2bbf9aefa2025-08-20T03:21:31ZengWileyPharmacology Research & Perspectives2052-17072025-06-01133n/an/a10.1002/prp2.70107Psychotropic Polypharmacy and QT Prolonging Medications in Hospitalized PatientsJoel Moore0Isabella Singh1Ruby Tszwai Au2Genevieve Gabb3Joanne Eng‐Frost4Elizabeth Hotham5Sepehr Shakib6Vijayaprakash Suppiah7UniSA Clinical and Health Sciences University of South Australia Adelaide South Australia AustraliaUniSA Clinical and Health Sciences University of South Australia Adelaide South Australia AustraliaUniSA Clinical and Health Sciences University of South Australia Adelaide South Australia AustraliaDepartment of Cardiovascular Medicine Flinders Medical Centre Bedford Park South Australia AustraliaDepartment of Cardiovascular Medicine Flinders Medical Centre Bedford Park South Australia AustraliaUniSA Clinical and Health Sciences University of South Australia Adelaide South Australia AustraliaDepartment of Clinical Pharmacology The Royal Adelaide Hospital Adelaide South Australia AustraliaUniSA Clinical and Health Sciences University of South Australia Adelaide South Australia AustraliaABSTRACT It is common for patients with mental illnesses to be prescribed multiple psychotropic medications to effectively manage their conditions. Psychotropic polypharmacy has been shown to potentiate and increase the risks of several adverse effects, including QT prolongation. This study aimed to investigate the prescribing trends of and differences in prescribing of QT‐prolonging medications (QTPMs) at admission and discharge in hospitalized patients. This retrospective observational study utilized inpatient data from three public hospitals between January and December 2019. QTPMs were classified according to the AZCERT classification. QTPMs doses were evaluated by calculating the ratio of prescribed daily dose (PDD) to the defined daily dose (DDD). Subgroup analyses showed significant differences between patient groups on admission and discharge (all p < 0.001). Mean QTPMs decreased significantly between the two time points only in patients admitted to acute medical and geriatric units (p < 0.001). PDD/DDD ratio for conditional risk QTPMs in acute mental health unit (AMHU) patients was increased at discharge (p = 0.038). Patients admitted to acute medical and geriatric units were four and eight times more likely to be discharged with one QTPM with known risk in combination with more QTPMs with conditional risk. Logistic regression showed significant relationships with age and total number of regular medicines at admission for those prescribed high‐dose QTPMs at discharge. The findings underscore the necessity for enhanced monitoring of QTPMs in hospitalized patients, particularly for those at higher risk.https://doi.org/10.1002/prp2.70107 |
| spellingShingle | Joel Moore Isabella Singh Ruby Tszwai Au Genevieve Gabb Joanne Eng‐Frost Elizabeth Hotham Sepehr Shakib Vijayaprakash Suppiah Psychotropic Polypharmacy and QT Prolonging Medications in Hospitalized Patients Pharmacology Research & Perspectives |
| title | Psychotropic Polypharmacy and QT Prolonging Medications in Hospitalized Patients |
| title_full | Psychotropic Polypharmacy and QT Prolonging Medications in Hospitalized Patients |
| title_fullStr | Psychotropic Polypharmacy and QT Prolonging Medications in Hospitalized Patients |
| title_full_unstemmed | Psychotropic Polypharmacy and QT Prolonging Medications in Hospitalized Patients |
| title_short | Psychotropic Polypharmacy and QT Prolonging Medications in Hospitalized Patients |
| title_sort | psychotropic polypharmacy and qt prolonging medications in hospitalized patients |
| url | https://doi.org/10.1002/prp2.70107 |
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