Category: Federal Forum Posters
Purpose: Amiodarone is a Class III antiarrhythmic with a unique pharmacological and pharmacokinetic profile that makes it useful for the treatment of ventricular and supraventricular arrhythmias. To ensure safe use, diligent monitoring is required to avoid severe, life-threatening toxicities that can potentially occur. Studies indicate that the complex management of patients on amiodarone therapy results in suboptimal monitoring. This medication use evaluation is designed to evaluate the practices of amiodarone monitoring at a VA hospital to ensure safe use. The reviewers will assess if clinicians are appropriately monitoring amiodarone and whether an opportunity exists for improvement in therapy management.
Methods: This MUE is designed as a retrospective chart review from July 1, 2016 to July 1, 2017 (established patients) or January 1, 2016-December 31,2017 (new starts). The electronic medical record will be used to identify two groups of patients: those who fill a new prescription for amiodarone and those patients who refill a prescription who began therapy at least six months prior. Adherence to published amiodarone monitoring management guides available in the literature will be assessed. The following data will be collected from patients established on amiodarone therapy: age, gender, indication, maintenance dose, prescriber specialty, duration of therapy, biannual labs collected (thyroid stimulating hormone (TSH) and liver function tests (LFTs)), annual labs collected (chest x-ray (CXR), electrocardiogram (ECG)). The following data will be collected from new patients: age, gender, amiodarone indication, initiation setting, amiodarone starting dosage, and initiating provider specialty. The following baseline monitoring parameters will be assessed: CXR, ECG, pulmonary function tests (PFTs), ECG, TSH/free T4/total or free T3, and LFTs.
Results: Not applicable
Conclusion: Not applicable
Catherine Miller– PGY1 Pharmacy Resident, Dayton VA Medical Center, Dayton, OH