Domperidone Prescribing Practices Exposed Patients to Cardiac Risk despite a “Black Box” Warning: A Canadian Tertiary Care Center Study
Background. In 2012, Health Canada released a warning regarding domperidone use, based on associations with life-threatening arrhythmias and death. Objective. This study aimed to compare the appropriateness of domperidone prescribing patterns before the advisory to those afterward. Methods. Two retr...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2016/2937678 |
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| author | Nauzer Forbes Mohan Cooray Raed Al-Dabbagh Yuhong Yuan Frances Tse Louis W. C. Liu Ted Xenodemetropoulos |
| author_facet | Nauzer Forbes Mohan Cooray Raed Al-Dabbagh Yuhong Yuan Frances Tse Louis W. C. Liu Ted Xenodemetropoulos |
| author_sort | Nauzer Forbes |
| collection | DOAJ |
| description | Background. In 2012, Health Canada released a warning regarding domperidone use, based on associations with life-threatening arrhythmias and death. Objective. This study aimed to compare the appropriateness of domperidone prescribing patterns before the advisory to those afterward. Methods. Two retrospective reviews were conducted for patients prescribed domperidone during quarters in 2005 and 2012. Outcomes included appropriateness of indication, dosing regimens, monitoring of electrolytes, baseline electrocardiogram performance and characteristics, presence of left ventricular dysfunction, and coprescription of QT-prolonging medications. Univariable and multivariable logistic regression analyses were performed. p values < 0.05 were considered significant. Results. 290 and 287 patients were analyzed in 2005 and 2012, respectively. Domperidone initiation in hospital decreased from 2005 to 2012 (71.4% versus 39.4%, p<0.0001) as did prescriptions for nonapproved indications (84.8% versus 58.2%, p<0.0001). In-hospital initiation predicted prescription for nonapproved indications (OR = 7.01, 95% CI 4.52–10.87, p<0.0001). Use of domperidone as the sole GI drug predicted nonapproved indications (OR = 2.51, 95% CI 1.38–4.55, p=0.002). Conclusions. The advisory was associated with more appropriate domperidone initiation and compliance with recommended dosages. Our study suggests the need for increased awareness of the dosing and monitoring of domperidone to ensure patient safety. |
| format | Article |
| id | doaj-art-c6d6619f82034b4eb5af97e13400dd04 |
| institution | Kabale University |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-c6d6619f82034b4eb5af97e13400dd042025-02-03T01:32:41ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972016-01-01201610.1155/2016/29376782937678Domperidone Prescribing Practices Exposed Patients to Cardiac Risk despite a “Black Box” Warning: A Canadian Tertiary Care Center StudyNauzer Forbes0Mohan Cooray1Raed Al-Dabbagh2Yuhong Yuan3Frances Tse4Louis W. C. Liu5Ted Xenodemetropoulos6Division of Gastroenterology, McMaster University Department of Medicine, Hamilton, ON, L8S 4K1, CanadaDivision of Gastroenterology, McMaster University Department of Medicine, Hamilton, ON, L8S 4K1, CanadaDivision of Gastroenterology, McMaster University Department of Medicine, Hamilton, ON, L8S 4K1, CanadaFarncombe Family Digestive Research Institute, Hamilton, ON, L8S 4K1, CanadaDivision of Gastroenterology, McMaster University Department of Medicine, Hamilton, ON, L8S 4K1, CanadaDivision of Gastroenterology, University of Toronto Department of Medicine, Toronto, ON, M5T 2S8, CanadaDivision of Gastroenterology, McMaster University Department of Medicine, Hamilton, ON, L8S 4K1, CanadaBackground. In 2012, Health Canada released a warning regarding domperidone use, based on associations with life-threatening arrhythmias and death. Objective. This study aimed to compare the appropriateness of domperidone prescribing patterns before the advisory to those afterward. Methods. Two retrospective reviews were conducted for patients prescribed domperidone during quarters in 2005 and 2012. Outcomes included appropriateness of indication, dosing regimens, monitoring of electrolytes, baseline electrocardiogram performance and characteristics, presence of left ventricular dysfunction, and coprescription of QT-prolonging medications. Univariable and multivariable logistic regression analyses were performed. p values < 0.05 were considered significant. Results. 290 and 287 patients were analyzed in 2005 and 2012, respectively. Domperidone initiation in hospital decreased from 2005 to 2012 (71.4% versus 39.4%, p<0.0001) as did prescriptions for nonapproved indications (84.8% versus 58.2%, p<0.0001). In-hospital initiation predicted prescription for nonapproved indications (OR = 7.01, 95% CI 4.52–10.87, p<0.0001). Use of domperidone as the sole GI drug predicted nonapproved indications (OR = 2.51, 95% CI 1.38–4.55, p=0.002). Conclusions. The advisory was associated with more appropriate domperidone initiation and compliance with recommended dosages. Our study suggests the need for increased awareness of the dosing and monitoring of domperidone to ensure patient safety.http://dx.doi.org/10.1155/2016/2937678 |
| spellingShingle | Nauzer Forbes Mohan Cooray Raed Al-Dabbagh Yuhong Yuan Frances Tse Louis W. C. Liu Ted Xenodemetropoulos Domperidone Prescribing Practices Exposed Patients to Cardiac Risk despite a “Black Box” Warning: A Canadian Tertiary Care Center Study Canadian Journal of Gastroenterology and Hepatology |
| title | Domperidone Prescribing Practices Exposed Patients to Cardiac Risk despite a “Black Box” Warning: A Canadian Tertiary Care Center Study |
| title_full | Domperidone Prescribing Practices Exposed Patients to Cardiac Risk despite a “Black Box” Warning: A Canadian Tertiary Care Center Study |
| title_fullStr | Domperidone Prescribing Practices Exposed Patients to Cardiac Risk despite a “Black Box” Warning: A Canadian Tertiary Care Center Study |
| title_full_unstemmed | Domperidone Prescribing Practices Exposed Patients to Cardiac Risk despite a “Black Box” Warning: A Canadian Tertiary Care Center Study |
| title_short | Domperidone Prescribing Practices Exposed Patients to Cardiac Risk despite a “Black Box” Warning: A Canadian Tertiary Care Center Study |
| title_sort | domperidone prescribing practices exposed patients to cardiac risk despite a black box warning a canadian tertiary care center study |
| url | http://dx.doi.org/10.1155/2016/2937678 |
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