Assessment of inappropriate prescribing of QT interval-prolonging drugs in end-stage renal disease patients in Jordan

Background Despite the high risk of life-threatening complications due to drug-induced prolongation of the corrected QT interval (QTcP) in patients with end-stage renal disease (ESRD), the safety of QTcP-inducing drugs has rarely been investigated in this patient population. Objectives This study aimed to assess the appropriateness of prescriptions for QTcP-inducing drugs and evaluate potential drug-drug interactions (DDIs) in patients with ESRD in Jordan. Methods This study was a retrospective observational study conducted from October 2019 to March 2020 in the outpatient clinics of 36 healthcare facilities across Jordan. A standardized data collection form was developed and used by pharmacy staff to collect data from the electronic databases of these facilities. The targeted population was patients with ESRD, specifically their prescriptions. Micromedex Drug Reax (R) software was used to check potential DDIs. Data were analysed using SPSS v26 software. Results The study included 407 patients with ESRD, who were prescribed 954 drugs with a risk of inducing QTcP. Of these, 17.6% were considered inappropriate application, 12.9% inappropriate choice, and 26.4% inappropriate decision. Roughly two-thirds of the dispensed drugs (64.8%) were associated with a DDI, 10.4% of which were major, 29.3% moderate, and 60.3% minor. Predictors for major DDIs were major polypharmacy, type of clinic and geographic location. Predictors for inappropriate prescribing were type of clinic and geographic location. Conclusion High rates of DDIs and inappropriate prescribing of QTcP-inducing drugs were reported among patients with ESRD in outpatient clinics in Jordan.