Prescription practices, experiences, and perspectives on the usage of hydroxychloroquine among rheumatologists and other specialists
Background/Objectives: The use of hydroxychloroquine (HCQ) for COVID-19 has raised concerns for adverse effects. We aimed to understand the practice, perceptions, and experience of adverse drug reactions (ADRs) with HCQ use for COVID-19 and other indications. Methods: A validated e-survey with 30 qu...
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Wolters Kluwer Medknow Publications
2021-01-01
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doaj-8aaebfdd917748fd9d9d3cd3a4534f4a2021-07-07T10:50:42ZengWolters Kluwer Medknow PublicationsIndian Journal of Rheumatology0973-36980973-37012021-01-0116216917810.4103/injr.injr_319_20Prescription practices, experiences, and perspectives on the usage of hydroxychloroquine among rheumatologists and other specialistsR NaveenAlka VermaHussain Ahmed RazaK G ChengappaG S K R NaiduSupriya SharmaAshish GoelDurga Prasanna MisraAman SharmaLatika GuptaVikas AgarwalBackground/Objectives: The use of hydroxychloroquine (HCQ) for COVID-19 has raised concerns for adverse effects. We aimed to understand the practice, perceptions, and experience of adverse drug reactions (ADRs) with HCQ use for COVID-19 and other indications. Methods: A validated e-survey with 30 questions was circulated among rheumatologists and other specialists using SurveyMonkey. Responses from rheumatologists were compared with other doctors (odds ratio [OR], median, interquartile range), and ADRs encountered based on their indications. Results: Among 410 respondents (71.2% rheumatologists, 27% academicians) with a lifetime experience of 17886 (4884–52074) patients over 12 (7–20) years, and 148 (48–349) prescription of HCQ per month, one-third (135) were managing COVID-19 with 10 (0–60) prescriptions per physician. Electrocardiograms were seldom ordered preprescription (5%), but visual scans were requested by one-thirds, especially by rheumatologists (OR-1.9). Agreement on the safety of HCQ for non-COVID indications was nearly unanimous (99%), but only two-third (64%) perceived it to be safe for COVID-19, with most (72%) being uncomfortable using HCQ with macrolides. ADRs were most often encountered after middle-age with skin pigmentation (554 [123–2063]) being the most frequent, followed by gastrointestinal intolerance (222 [42–980] per million prescriptions). Cardiac toxicity was rarely reported. ADRs other than cutaneous and visual were noted more frequently by nonrheumatologists. Rheumatologists were less likely to consider HCQ unsafe (OR-0.04) and reportedly faced a greater challenge in drug procurance (OR-2.6) during the pandemic. Conclusions: Most ADRs are rare with HCQ use in our respondent population with a large user experience. HCQ use was considered unsafe by one-thirds in the setting of COVID-19 but not outside it, lesser so by rheumatologists.http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2021;volume=16;issue=2;spage=169;epage=178;aulast=Naveencovid-19drug-related side effects and adverse reactionshydroxychloroquinepracticessurveys and questionnaires |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
R Naveen Alka Verma Hussain Ahmed Raza K G Chengappa G S K R Naidu Supriya Sharma Ashish Goel Durga Prasanna Misra Aman Sharma Latika Gupta Vikas Agarwal |
spellingShingle |
R Naveen Alka Verma Hussain Ahmed Raza K G Chengappa G S K R Naidu Supriya Sharma Ashish Goel Durga Prasanna Misra Aman Sharma Latika Gupta Vikas Agarwal Prescription practices, experiences, and perspectives on the usage of hydroxychloroquine among rheumatologists and other specialists Indian Journal of Rheumatology covid-19 drug-related side effects and adverse reactions hydroxychloroquine practices surveys and questionnaires |
author_facet |
R Naveen Alka Verma Hussain Ahmed Raza K G Chengappa G S K R Naidu Supriya Sharma Ashish Goel Durga Prasanna Misra Aman Sharma Latika Gupta Vikas Agarwal |
author_sort |
R Naveen |
title |
Prescription practices, experiences, and perspectives on the usage of hydroxychloroquine among rheumatologists and other specialists |
title_short |
Prescription practices, experiences, and perspectives on the usage of hydroxychloroquine among rheumatologists and other specialists |
title_full |
Prescription practices, experiences, and perspectives on the usage of hydroxychloroquine among rheumatologists and other specialists |
title_fullStr |
Prescription practices, experiences, and perspectives on the usage of hydroxychloroquine among rheumatologists and other specialists |
title_full_unstemmed |
Prescription practices, experiences, and perspectives on the usage of hydroxychloroquine among rheumatologists and other specialists |
title_sort |
prescription practices, experiences, and perspectives on the usage of hydroxychloroquine among rheumatologists and other specialists |
publisher |
Wolters Kluwer Medknow Publications |
series |
Indian Journal of Rheumatology |
issn |
0973-3698 0973-3701 |
publishDate |
2021-01-01 |
description |
Background/Objectives: The use of hydroxychloroquine (HCQ) for COVID-19 has raised concerns for adverse effects. We aimed to understand the practice, perceptions, and experience of adverse drug reactions (ADRs) with HCQ use for COVID-19 and other indications.
Methods: A validated e-survey with 30 questions was circulated among rheumatologists and other specialists using SurveyMonkey. Responses from rheumatologists were compared with other doctors (odds ratio [OR], median, interquartile range), and ADRs encountered based on their indications.
Results: Among 410 respondents (71.2% rheumatologists, 27% academicians) with a lifetime experience of 17886 (4884–52074) patients over 12 (7–20) years, and 148 (48–349) prescription of HCQ per month, one-third (135) were managing COVID-19 with 10 (0–60) prescriptions per physician. Electrocardiograms were seldom ordered preprescription (5%), but visual scans were requested by one-thirds, especially by rheumatologists (OR-1.9). Agreement on the safety of HCQ for non-COVID indications was nearly unanimous (99%), but only two-third (64%) perceived it to be safe for COVID-19, with most (72%) being uncomfortable using HCQ with macrolides. ADRs were most often encountered after middle-age with skin pigmentation (554 [123–2063]) being the most frequent, followed by gastrointestinal intolerance (222 [42–980] per million prescriptions). Cardiac toxicity was rarely reported. ADRs other than cutaneous and visual were noted more frequently by nonrheumatologists. Rheumatologists were less likely to consider HCQ unsafe (OR-0.04) and reportedly faced a greater challenge in drug procurance (OR-2.6) during the pandemic.
Conclusions: Most ADRs are rare with HCQ use in our respondent population with a large user experience. HCQ use was considered unsafe by one-thirds in the setting of COVID-19 but not outside it, lesser so by rheumatologists. |
topic |
covid-19 drug-related side effects and adverse reactions hydroxychloroquine practices surveys and questionnaires |
url |
http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2021;volume=16;issue=2;spage=169;epage=178;aulast=Naveen |
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