서브메뉴
검색
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 Sudden Cardiac Death Among Older Adults With Cancer
상세정보
- 자료유형
- 학위논문 서양
- 최종처리일시
- 20260202103124
- ISBN
- 9798315705161
- DDC
- 614.4
- 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
- 로그인 후 원문을 볼 수 있습니다.
MARC
008260126s2025 us c eng d■001000017357061
■00520260202103124
■006m o d
■007cr#unu||||||||
■020 ▼a9798315705161
■035 ▼a(MiAaPQ)AAI31938586
■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.


