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

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...

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Autores principales:	Zolezzi M, Elhakim A, Elamin WM, Homs S, Mahmoud DE, Qubaiah IA
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	drug-induced arrythmias qtc prolongation algorithm psychiatric population Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/3a2a14bc69f044499f5244843ac4ee58
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spelling	oai:doaj.org-article:3a2a14bc69f044499f5244843ac4ee582021-11-21T19:08:50ZContent Validation of an Algorithm for the Assessment, Management and Monitoring of Drug-Induced QTc Prolongation in the Psychiatric Population1178-2021https://doaj.org/article/3a2a14bc69f044499f5244843ac4ee582021-11-01T00:00:00Zhttps://www.dovepress.com/content-validation-of-an-algorithm-for-the-assessment-management-and-m-peer-reviewed-fulltext-article-NDThttps://doaj.org/toc/1178-2021Monica 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 +974 4403-5623Email mzolezzi@qu.edu.qaBackground: 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 of the steps as they appear to be cumbersome.Conclusion: The results demonstrate that the implementation of the algorithm after minor alterations can prove to be useful as a tool for the risk assessment of QTc prolongation. Further validation of the algorithm with mental health pharmacists and clinicians will be conducted as a separate phase of the study.Keywords: drug-induced arrhythmias, QTc prolongation, algorithm, psychiatric populationZolezzi MElhakim AElamin WMHoms SMahmoud DEQubaiah IADove Medical Pressarticledrug-induced arrythmiasqtc prolongationalgorithmpsychiatric populationNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 17, Pp 3395-3405 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	drug-induced arrythmias qtc prolongation algorithm psychiatric population Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	drug-induced arrythmias qtc prolongation algorithm psychiatric population Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Zolezzi M Elhakim A Elamin WM Homs S Mahmoud DE Qubaiah IA Content Validation of an Algorithm for the Assessment, Management and Monitoring of Drug-Induced QTc Prolongation in the Psychiatric Population
description	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 +974 4403-5623Email mzolezzi@qu.edu.qaBackground: 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 of the steps as they appear to be cumbersome.Conclusion: The results demonstrate that the implementation of the algorithm after minor alterations can prove to be useful as a tool for the risk assessment of QTc prolongation. Further validation of the algorithm with mental health pharmacists and clinicians will be conducted as a separate phase of the study.Keywords: drug-induced arrhythmias, QTc prolongation, algorithm, psychiatric population
format	article
author	Zolezzi M Elhakim A Elamin WM Homs S Mahmoud DE Qubaiah IA
author_facet	Zolezzi M Elhakim A Elamin WM Homs S Mahmoud DE Qubaiah IA
author_sort	Zolezzi M
title	Content Validation of an Algorithm for the Assessment, Management and Monitoring of Drug-Induced QTc Prolongation in the Psychiatric Population
title_short	Content Validation of an Algorithm for the Assessment, Management and Monitoring of Drug-Induced QTc Prolongation in the Psychiatric Population
title_full	Content Validation of an Algorithm for the Assessment, Management and Monitoring of Drug-Induced QTc Prolongation in the Psychiatric Population
title_fullStr	Content Validation of an Algorithm for the Assessment, Management and Monitoring of Drug-Induced QTc Prolongation in the Psychiatric Population
title_full_unstemmed	Content Validation of an Algorithm for the Assessment, Management and Monitoring of Drug-Induced QTc Prolongation in the Psychiatric Population
title_sort	content validation of an algorithm for the assessment, management and monitoring of drug-induced qtc prolongation in the psychiatric population
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/3a2a14bc69f044499f5244843ac4ee58
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Content Validation of an Algorithm for the Assessment, Management and Monitoring of Drug-Induced QTc Prolongation in the Psychiatric Population

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