Content Validation of an Algorithm for the Assessment, Management and Monitoring of Drug-Induced QTc Prolongation in the Psychiatric Population

• Main Authors: Zolezzi M, Elhakim A, Elamin WM, Homs S, Mahmoud DE, Qubaiah IA
• Format: Article in Journal/Newspaper
• Language: English
• Published: Dove Medical Press 2021
• Subjects: drug-induced arrythmias; qtc prolongation; algorithm; psychiatric population; Neurosciences. Biological psychiatry. Neuropsychiatry; RC321-571; Neurology. Diseases of the nervous system; RC346-429; North Atlantic
• Online Access: https://doaj.org/article/3a2a14bc69f044499f5244843ac4ee58

Monica Zolezzi,1 Athar Elhakim,2 Waad M Elamin,1 Shorouk Homs,1 Doaa E Mahmoud,1 Iman A Qubaiah1 1College of Pharmacy, QU Health, Qatar University, Doha, Qatar; 2School of Health Sciences, College of North Atlantic Qatar, Doha, QatarCorrespondence: Monica ZolezziCollege of Pharmacy, QU Health, Qatar University, Doha, QatarTel [phone]Email [e-mail]: QTc interval (QTcI) prolongation leads to serious complications, making it a concern for clinicians. Assessing the risk of QTcI prolongation in the psychiatric population is important because they are exposed to multiple medications known to increase the risk of life-threatening arrhythmias.Aim: The study aims to validate the content of an algorithm for the assessment, management and monitoring of drug-induced QTc prolongation in the psychiatric population.Methodology: Qualitative semi-structured interviews of cardiologists, to gather information regarding their approach in assessing the risk of drug-induced QTc prolongation at the time of prescribing. After the interview, an orientation to the algorithm was provided with a link to a cross-sectional, anonymous survey. The online survey included quantitative and qualitative components to gather feedback on the relevance and appropriateness of each step in the algorithm.Results: Interview responses were incorporated into 4 themes. Responses indicated a lack of a unified protocol when assessing QTcI prolongation, which supports the need of an algorithm that includes a verified risk scoring tool. Quantitative survey results showed a mean score ranging from 3.08 to 3.67 out of 4 for the appropriateness of the algorithm’s steps, 3.08 to 3.58 for the safety and 3.17 to 3.75 for the reliability of references used. Additional analysis using the modified kappa and I-CVI statistical measures indicate high validity of contents and high degree of agreement between raters. As per the open-ended questions, cardiologists supported the implementation of the algorithm; however, they recommended simplification ...