Project summary in plain language

QTc Risk Potential in Palliative Care

Risk Potential of QTc time-prolonging Drugs in Palliative Care Patients

 

Patient group

In palliative care, the focus is on improving the patient's quality of life. Although drug therapies are essential for treating distressing symptoms, they also carry risks, such as prolonging the QTc time in the heart. Around 20% of inpatients receiving palliative oncology treatment exhibit prolonged QTc times. The clinical relevance of QTc prolonging drugs in patients with limited life expectancy remains unclear, as does the applicability of risk scores from other medical disciplines.

Aim

Characterization of the risk and possible risk factors of drug-induced QTc time prolongation in palliative care patients and development of practice-relevant recommendations for dealing with high-risk drugs in palliative care.

Implementation

A mixed-methods study was conducted, including a retrospective analysis of patient charts (1), to identify risk drugs and contributing factors. A subsequent focus group discussion (2) was held with experts in palliative medicine, cardiology and clinical pharmacy to discuss QT risk management in clinical practice. The results will inform the development of recommendations to be implemented as quality management measures in the palliative care unit. A second retrospective file analysis will be conducted after implementation to identify changes to QT risk management.

Result

The recommendations developed within this project aim to reduce the knowledge gab about QTc time prolongation in this setting. This should help to identify the factors that indicate when ECG monitoring is appropriate in palliative care.

Patient benefit

Easier identification of palliative care patients at increased risk of QTc time prolongation enables the development of a concrete monitoring strategy appropriate to their situation, through targeted diagnostics and drug selection guidance. In this way, we hope to significantly increase both the safety of drug therapy and the quality of life of patients.

 

 

Figure 1: Graphical representation of the methodology of the mixed-methods study

Image source: Stefanie Vahlbrock