Adherence to Amiodarone Monitoring Recommendations Before and After Implementation of a Centralized Pharmacy Service: A Cohort Study
Abstract
The objective of this study was to determine whether patients enrolled in a centralized amiodarone monitoring service (AMS) were more adherent to amiodarone surveillance and whether the incidence of amiodarone-related toxicity differed for patients who were enrolled in the AMS. Amiodarone therapy was initiated in 917 patients in an integrated health care delivery system between October 1998 and December 2006. Electronic records were queried to establish the proportion of patients completing recommended amiodarone monitoring during the first year of therapy; specifically, thyroid stimulating hormone (TSH), alanine aminotransferase (ALT), electrocardiogram (ECG), and chest radiograph (CXR). Patients were assigned to the AMS or control cohort based on when amiodarone was initiated. Patients assigned to the AMS cohort were more likely to receive ALT monitoring at baseline, 6 months, and 1 year (68% vs 44%, P < .001; 86% vs 76%, P = .002; 84% vs 69%, P < .001; respectively) and ECG monitoring at baseline and 1 year (76% vs 58%; 96% vs 75%, P < .001, respectively). There was no difference in TSH monitoring at baseline, 6 months, and 1 year (55% vs 49%, P = not significant [NS]; 74% vs 70%, P = NS; 68% vs 64%, P = NS; respectively).
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Studies evaluating the adequacy of monitoring for adverse effects from amiodarone have shown suboptimal results.
“Studies evaluating the adequacy of monitoring for adverse effects from amiodarone have shown suboptimal results (577,578).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [578]
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Ross, D. S., Burch, H. B., Cooper, D. S., Greenlee, M. C., Laurberg, P., Maia, A. L., Rivkees, S. A., Samuels, M., Sosa, J. A., Stan, M. N., et al. (2016) · Thyroid® · doi:10.1089/thy.2016.0229 · Cited by 2,938 · see citing works
“Studies evaluating the adequacy of monitoring for adverse effects from amiodarone have shown suboptimal results (577,578).”
Background
- Authors
- Johnson, S. G., Canty, K., Billups, S., & Schimmer, J.
- Affiliations
- Kaiser Permanente (US)
- Corresponding author
- Johnson, Samuel G.
- Venue
- Journal of Pharmacy Practice
- Publisher
- SAGE Publications
- Published
- 2010-04-14
- Volume
- 23
- Issue
- 6
- Pages
- 536-539
- ISSN
- 0897-1900 (ISSN-L)
- 1531-1937
- OpenAlex
- W2062260138
- Cited by
- 14
- References
- 11
- Citations by year
- 2024: 1 · 2020: 1 · 2018: 1 · 2017: 2 · 2016: 4 · 2015: 1 · 2014: 2 · 2012: 1
- FWCI
- 0.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Pharmacy Practice (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- amiodarone, drug monitoring, medication adherence, amiodarone toxicity, ECG monitoring, chest radiograph, adverse drug reactions, anticoagulation monitoring
- MeSH terms
- Aged, Alanine Transaminase, Ambulatory Care, Amiodarone, Anti-Arrhythmia Agents, Cardiology, Commission on Professional and Hospital Activities, Electrocardiography, Female, Humans, Male, Pharmaceutical Services, Thyrotropin, Time Factors, Cohort Studies, Drug Monitoring, Electronic Health Records
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