Amiodarone Pharmacovigilance Through an Intelligent Electronic Health Record Application

Olivia R. Newgaard, BA; Rajeev Chaudhry, MBBS, MPH; Jenny A. Schutte, RN; Richard Arndt, PharmD; Jennifer R. Rich, MPH; Andrew D. Calvin, MD, MPH; Richard D. Hanna, MD

WMJ. 2023;122(4):280-283.

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ABSTRACT

Background: Amiodarone is the most effective and commonly used antiarrhythmic medication. Given its risk of toxicity, routine monitoring is recommended but is challenging to ensure in clinical practice.

Methods: We created an intelligent application, built within our electronic health record, that identified every living patient with an active outpatient prescription by a clinician in our health system. The application was designed to identify patients with lapses in recommended monitoring and facilitate scheduling of overdue testing.

Results: The percentage of patients with overdue monitoring tests decreased with use of the application, with greatest improvement in pulmonary function testing.

Discussion: Implementing a program to monitor and mitigate adverse reactions to amiodarone by using programable features of an electronic health record is feasible.

Author Affiliations: Medical College of Wisconsin, Wausau, Wisconsin (Newgaard); Division of Community Internal Medicine, Geriatrics, and Palliative Medicine and Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, Minnesota (Chaudhry); Department of Nursing (Schutte), Pharmacy Services (Arndt), Research and Innovation (Rich), and Cardiology (Calvin, Hanna), Mayo Clinic Health System – Northwest Wisconsin Region, Eau Claire, Wisconsin.
Corresponding Author: Richard D. Hanna, MD, Cardiology, Mayo Clinic Health System – Northwest Wisconsin Region, 1400 Bellinger St, Eau Claire, WI 54703; phone 715.838.6320; email hanna.richard@mayo.edu; ORCID ID 0000-0002-5148-6683
Acknowledgments: The authors wish to thank Lorraine D. Rongstad and Susanne C. Degen for administrative support and Amber M. Bolles, MA, Ambulatory Documentations Systems for programming support. The Scientific Publications staff at Mayo Clinic provided editorial consultation, proofreading, and administrative and clerical support.
Funding/Support: This project was supported through a a 2020 Mayo Clinic Midwest Clinical Practice Committee Project Innovation Grant.
Financial Disclosures: None declared.

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