Adherence to Monitoring Guidelines of Amiodarone Adverse Reactions

BACKGROUND: Amiodarone treatment frequently causes adverse reactions. Clinical guidelines warrant a comprehensive assessment prior to chronic treatment with amiodarone and repeated monitoring for the appearance of adverse reactions. OBJECTIVE: To evaluate adherence to these guidelines. METHODS: A retrospective chart review of electronic medical records of adult patients treated with oral amiodarone for at least 12 months. RESULTS: One hundred patient records were analyzed; 97% of patients were evaluated for thyroid and liver functions prior to treatment. Liver functions were properly monitored every 6 months in 96% of patients and thyroid function in only 59%. Most (84%) patients completed a chest X-ray before treatment; only 2% completed a respiratory function test. None have performed a chest X-ray annually. Sixty-four percent of the patients were examined by an ophthalmologist prior to treatment; periodic ophthalmic surveillance was not consistent. Neurological and dermatological evaluations were not recorded for any of the patients, unless symptoms appeared. Only 50% were adherent to annual cardiac reassessment. CONCLUSIONS: Adherence to recommended clinical guidelines for monitoring amiodarone adverse reactions is poor. Interventions to improve compliance with these guidelines are needed.