Electronic health records can be used to help identify patients on antidepressants and other drugs at greater risk for heart arrhythmia, according to a new study in BMJ.
Certain medications can precipitate changes in heart function that can cause fatal arrhythmia. These changes can be characterized by prolonged QT intervals on an electrocardiogram. The researchers, from Boston-based Partners HealthCare System and elsewhere, examined the EHRs of 38,397 adult patients who had electrocardiograms within 90 days of being prescribed certain antidepressants, or the opioid methadone.
They found "statistically significant evidence" of QT prolongation for methadone and some of the antidepressants, meaning that those patients were at greater risk of suffering arrhythmia. The findings corroborated recent U.S. Food and Drug Administration warnings about this risk.
"Our results suggest that, given its capacity to shorten QT interval, bupropion treatment might be a reasonable next step for patients partially responsive to citalopram who would otherwise require a dose increase," the study's authors said.
Researchers credited the use of EHRs in helping them conduct their research, noting that the EHR's ability to sift through a large number of records enabled them to detect subtle changes in QT intervals that might have otherwise gone unnoticed. They also suggested that because EHRs cover more records than in a randomized trial, they may be better in identifying risk in patients on multiple medications or with multiple medical disorders.
Other studies have recognized the benefits of using the broad search capabilities of EHRs to detect previously unreported problems and better coordinate patients' care.
To learn more:
- read the study
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