Wendl E, Telles N, Wall GC. Survey concerning internal medicine physicians and prolonged QT interval: Knowledge and treatment practices. World J Cardiol 2021; 13(3): 42-45 [PMID: 33791077 DOI: 10.4330/wjc.v13.i3.42]
Corresponding Author of This Article
Geoff C Wall, BCPS, FCCP, PharmD, Professor, Department of Pharmacy Practice, Drake University College of Pharmacy and Health Sciences, 2507 University Ave, Des Moines, IA 50311, United States. geoff.wall@drake.edu
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Academic Activity Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Mar 26, 2021; 13(3): 42-45 Published online Mar 26, 2021. doi: 10.4330/wjc.v13.i3.42
Survey concerning internal medicine physicians and prolonged QT interval: Knowledge and treatment practices
Elizabeth Wendl, Nelson Telles, Geoff C Wall
Elizabeth Wendl, Department of Medical Education, Internal Medicine Residency Program, Iowa Methodist Medical Center, Des Moines, IA 50311, United States
Nelson Telles, Department of Cardiology, Internal Medicine Residency Program, Iowa Methodist Medical Center, Des Moines, IA 50311, United States
Geoff C Wall, Department of Pharmacy Practice, Drake University College of Pharmacy and Health Sciences, Des Moines, IA 50311, United States
Geoff C Wall, Internal Medicine Residency Program, Iowa Methodist Medical Center, Des Moines, IA 50311, United States
Author contributions: All authors contributed study design, acquisition, analysis, or interpretation of data, drafted the article or revised it critically for important intellectual content, approved the version to be published, agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Conflict-of-interest statement: No of the authors have real or potential conflicts of interest pertaining to this work.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Geoff C Wall, BCPS, FCCP, PharmD, Professor, Department of Pharmacy Practice, Drake University College of Pharmacy and Health Sciences, 2507 University Ave, Des Moines, IA 50311, United States. geoff.wall@drake.edu
Received: October 19, 2020 Peer-review started: October 19, 2020 First decision: December 1, 2020 Revised: December 3, 2020 Accepted: January 13, 2021 Article in press: January 13, 2021 Published online: March 26, 2021
Abstract
Prolongation of the QT interval is associated with adverse cardiac events specifically Torsades de pointes (TdP). There are multiple mediations that have a known, possible, or conditional risk for prolonged QT interval, but general practitioners’ knowledge of these medications is unknown. We conducted a survey to assess internal medicine (IM) providers’ knowledge of risk factors and medications associated with prolonged QT as well as provider experience and comfort when treating patients with prolonged QT. A 17-question, anonymous survey was constructed in 2019 and distributed to IM providers and residents at a tertiary care center. Questions included demographic information, 6 Likert-scale questions gauging provider experience with prolonged QT, and 10 multiple choice clinical vignettes to assess clinical knowledge. Data was analyzed descriptively. Knowledge was assessed via clinical vignettes and compared by level of training. Forty-one responses were received out of a total of 87 possible respondents (47.1% response rate). About 70% of respondents see patients with acquired prolonged QT once monthly or more. 95% rarely see congenital prolonged QT. When presented with QTc drug issues, 73% of providers seldom or sometimes consulted pharmacy, but about half used online resources. The average correct score on the clinical vignettes was 5.59/10, with the highest scores seen in attending physicians in their first five years of practice (6.96/10). Our survey suggests that IM providers commonly encounter QT prolonging drugs. Educational efforts to improve knowledge of drug and patient risk factors for TdP may be needed.
Core Tip: Knowledge of drugs that prolong the QTc interval and patient risk factors varies significantly among internal medicine physicians and trainees.
