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The Burden of Exposure and Monitoring of QT-Prolonging Drugs and the Transient Risk of Sudden Cardiac Death Among Older Adults With Cancer
The Burden of Exposure and Monitoring of QT-Prolonging Drugs and the Transient Risk of Sud...
The Burden of Exposure and Monitoring of QT-Prolonging Drugs and the Transient Risk of Sudden Cardiac Death Among Older Adults With Cancer

상세정보

자료유형  
 학위논문 서양
최종처리일시  
20260202103124
ISBN  
9798315705161
DDC  
614.4
저자명  
Schlusser, Courtney Lauren.
서명/저자  
The Burden of Exposure and Monitoring of QT-Prolonging Drugs and the Transient Risk of Sudden Cardiac Death Among Older Adults With Cancer
발행사항  
[Sl] : The University of North Carolina at Chapel Hill, 2025
발행사항  
Ann Arbor : ProQuest Dissertations & Theses, 2025
형태사항  
177 p
주기사항  
Source: Dissertations Abstracts International, Volume: 86-11, Section: B.
주기사항  
Advisor: Lund, Jennifer L.
학위논문주기  
Thesis (Ph.D.)--The University of North Carolina at Chapel Hill, 2025.
초록/해제  
요약Cancer is a leading cause of death in the United States and a major driver of polypharmacy among older adults. Many cancer treatments, particularly QT-prolonging medications, are associated with an increased risk of cardiotoxicity, including sudden cardiac death (SCD). This dissertation utilized SEER-Medicare data to investigate the burden, monitoring, and potential risks of QT-prolonging medications in older adults with cancer through two complementary studies. In Aim 1, we assessed the prevalence and temporal patterns of QT-prolonging medication exposure and electrocardiographic (ECG) monitoring across the cancer care trajectory. We found significant gaps in ECG monitoring, particularly during periods of high QT prolongation risk. These findings highlight critical opportunities to improve cardiac monitoring practices in this vulnerable population.In Aim 2, we evaluated the transient associations between QT-prolonging medication exposure and SCD using two self-controlled study designs. While SCD was a rare event, our results did not demonstrate a significant increase in SCD risk during hazard periods of QT-prolonging medication exposure. These findings underscore the importance of accounting for confounding factors and temporal trends when evaluating medication safety in older adults.Together, these studies provide a comprehensive assessment of QT-prolonging medication use and its implications in older adults with cancer. The findings emphasize the need for targeted interventions, including enhanced ECG monitoring and pharmacist-led medication reviews, to mitigate risks and improve patient outcomes. This dissertation contributes critical evidence to guide future research, inform clinical guidelines, and support equitable cancer care.
일반주제명  
Epidemiology
일반주제명  
Oncology
일반주제명  
Aging
키워드  
Cancer
키워드  
Cancer treatment
키워드  
Cardiotoxicity
기타저자  
The University of North Carolina at Chapel Hill Epidemiology
기본자료저록  
Dissertations Abstracts International. 86-11B.
전자적 위치 및 접속  
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■040    ▼aMiAaPQ▼cMiAaPQ
■0820  ▼a614.4
■1001  ▼aSchlusser,  Courtney  Lauren.
■24510▼aThe  Burden  of  Exposure  and  Monitoring  of  QT-Prolonging  Drugs  and  the  Transient  Risk  of  Sudden  Cardiac  Death  Among  Older  Adults  With  Cancer
■260    ▼a[Sl]▼bThe  University  of  North  Carolina  at  Chapel  Hill▼c2025
■260  1▼aAnn  Arbor▼bProQuest  Dissertations  &  Theses▼c2025
■300    ▼a177  p
■500    ▼aSource:  Dissertations  Abstracts  International,  Volume:  86-11,  Section:  B.
■500    ▼aAdvisor:  Lund,  Jennifer  L.
■5021  ▼aThesis  (Ph.D.)--The  University  of  North  Carolina  at  Chapel  Hill,  2025.
■520    ▼aCancer  is  a  leading  cause  of  death  in  the  United  States  and  a  major  driver  of  polypharmacy  among  older  adults.  Many  cancer  treatments,  particularly  QT-prolonging  medications,  are  associated  with  an  increased  risk  of  cardiotoxicity,  including  sudden  cardiac  death  (SCD).  This  dissertation  utilized  SEER-Medicare  data  to  investigate  the  burden,  monitoring,  and  potential  risks  of  QT-prolonging  medications  in  older  adults  with  cancer  through  two  complementary  studies.  In  Aim  1,  we  assessed  the  prevalence  and  temporal  patterns  of  QT-prolonging  medication  exposure  and  electrocardiographic  (ECG)  monitoring  across  the  cancer  care  trajectory.  We  found  significant  gaps  in  ECG  monitoring,  particularly  during  periods  of  high  QT  prolongation  risk.  These  findings  highlight  critical  opportunities  to  improve  cardiac  monitoring  practices  in  this  vulnerable  population.In  Aim  2,  we  evaluated  the  transient  associations  between  QT-prolonging  medication  exposure  and  SCD  using  two  self-controlled  study  designs.  While  SCD  was  a  rare  event,  our  results  did  not  demonstrate  a  significant  increase  in  SCD  risk  during  hazard  periods  of  QT-prolonging  medication  exposure.  These  findings  underscore  the  importance  of  accounting  for  confounding  factors  and  temporal  trends  when  evaluating  medication  safety  in  older  adults.Together,  these  studies  provide  a  comprehensive  assessment  of  QT-prolonging  medication  use  and  its  implications  in  older  adults  with  cancer.  The  findings  emphasize  the  need  for  targeted  interventions,  including  enhanced  ECG  monitoring  and  pharmacist-led  medication  reviews,  to  mitigate  risks  and  improve  patient  outcomes.  This  dissertation  contributes  critical  evidence  to  guide  future  research,  inform  clinical  guidelines,  and  support  equitable  cancer  care.
■590    ▼aSchool  code:  0153.
■650  4▼aEpidemiology
■650  4▼aOncology
■650  4▼aAging
■653    ▼aCancer
■653    ▼aCancer  treatment
■653    ▼aCardiotoxicity
■690    ▼a0766
■690    ▼a0992
■690    ▼a0769
■690    ▼a0493
■71020▼aThe  University  of  North  Carolina  at  Chapel  Hill▼bEpidemiology.
■7730  ▼tDissertations  Abstracts  International▼g86-11B.
■790    ▼a0153
■791    ▼aPh.D.
■792    ▼a2025
■793    ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17357061▼nKERIS▼z이  자료의  원문은  한국교육학술정보원에서  제공합니다.

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