gms | German Medical Science

25th Annual Meeting of the German Drug Utilisation Research Group (GAA)

Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie

22.11. - 23.11.2018, Bonn/Bad Godesberg

„QT-Life“: Prevention of adverse drug effects, in particular torsade de pointes-events, by pharmacy-based basic data collection

Meeting Abstract

  • author Thomas Bodmer - DAK – Gesundheit, Hamburg, Germany
  • author Matthias Augustin - Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
  • author Peter Froese - Apothekerverband Schleswig-Holstein e.V., Kiel, Germany
  • corresponding author presenting/speaker Timm Volmer - SmartStep Data Institute GmbH, Hamburg, Germany

Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie e.V. (GAA). 25. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie. Bonn/Bad Godesberg, 22.-23.11.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. Doc18gaa01

doi: 10.3205/18gaa01, urn:nbn:de:0183-18gaa014

Published: November 23, 2018

© 2018 Bodmer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Background: Some drugs cause QT prolongations that can lead to torsade de pointes arrhythmias and in 10 – 20% of cases to ventricular fibrillation and a sudden cardiac death (approximately 15.000 deaths per year in Germany) [1]. The intake of several QT-critical drugs may have an additive impact on the risk of QT prolongations [2]. Both prescribed medications and self-medications may comprise QT prolonging drugs.

The main objective of “QT-Life” is the improvement of drug safety regarding QT prolongations by: 1) The improvement of communication and cooperation between pharmacy and physician, 2) the early detection of QT prolongations, and 3) the prevention of secondary diseases by drug-induced QT prolongation.

Materials and methods: The objectives will be realized by the innovative and extended integration of pharmacies into the care process through an amendment of the interaction-check, the application of a handy ECG (Faros 180), and the electronical transfer of data to the attending physician.

Based on their prescription or OTC drugs the insured persons will be advised to undertake a pre-diagnostic risk analysis for QT prolongations by using a mobile ECG (24 h-ECG). The corresponding software identifies risk events in the course of the ECG (traffic light system: “green”, “yellow” or “red”). In case of “yellow” or “red“, a structured electronic communication with specific recommendations for the treating physician follows.

The target region for the innovation fund application of “QT-Life” is going to be Schleswig-Holstein. The project will be implemented as a randomised and controlled intervention study (n=3000) based on DAK-insured persons, who visit a pharmacy in Schleswig-Holstein and take or purchase QT-critical drugs.

Results: Based on the health insurers routine data it will be evaluated whether the proportion of the insured persons who take a QT-critical drug and/or the number of (relevant) hospitalisations decreases in comparison to the standard care.

Conclusion: Following the successful closing of the pilot project, the new form of care shall be transferred to standard care. Besides the improvement of the treatment of QT prolongations and drug safety, a further objective is health care cost containment in particular by avoiding emergency admissions and hospitalisations.


References

1.
Sekarski N, Boulos T, Di Bernardo S. Medikamente und Long-QT Syndrom [Drugs and Long-QT syndrome]. Paediatrica. 2008:37-41.
2.
Haverkamp W, Haverkamp F, Breithardt G. Medikamentenbedingte QT-Verlängerung und Torsade de pointes [Drug-related QT prolongation and torsade de pointes]. Dtsch Arztebl. 2002:28-9.