Assessment of Initial Digoxin Dosing and Monitoring Practices in Hospitalized Patients

Document Type

Conference Proceeding

Publication Date

3-6-2026

Publication Title

Am J Health Syst Pharm

Keywords

Pharmacology & Pharmacy

Abstract

Purpose: Digoxin is widely prescribed for atrial fibrillation and heart failure, but its narrow therapeutic index makes careful dosing and monitoring essential to avoid toxicity. Improper timing of serum digoxin measurements can result in misleading levels, potentially affecting clinical decision-making. This study aims to examine the appropriateness of digoxin prescribing and monitoring practices at a community teaching hospital. By evaluating adherence to the package insert dosing and monitoring recommendations, the study seeks to identify areas for improvement to enhance patient safety and optimize therapeutic outcomes. Methods: This retrospective, cross-sectional study will include adult inpatients who were initiated on digoxin during hospitalization and received therapy for at least four days, including a loading dose when applicable. Patients treated exclusively in the emergency department or identified as part of vulnerable populations will be excluded. Patient data will be collected from the electronic medical record and will include demographics, indication for digoxin therapy, loading and maintenance doses with renal adjustments, serum digoxin levels with timing relative to dose and steady state, renal function, concomitant interacting medications, clinical signs or symptoms of digoxin toxicity, and administration of digoxin immune Fab. The primary outcome is the proportion of patients with appropriate digoxin dosing and monitoring. Secondary outcomes include the frequency of correctly timed serum levels, the appropriateness of dose adjustments after renal function changes or the initiation/discontinuation of interacting drugs, and the appropriate use of digoxin immune Fab. Data will be summarized using descriptive statistics. A sample size of 100 patients was selected to provide sufficient representation of current practice patterns without formal power calculations.

Volume

83

First Page

S808

Find It @ Sladen

Share

COinS