Appropriateness evaluation
Appropriateness of prescriptions was assessed by a multidisciplinary committee; a consultant nephrologist, a consultant cardiologist, and a senior clinical pharmacist. The main investigator (DAN) arranged three online meetings (April 5-20, 2020) using Zoom©Software, 2 hours for each one with the experts to discuss the appropriateness of prescriptions. Their purpose was to judge the prescription appropriateness of QTcP-inducing drugs among the included patients. They reviewed all prescriptions and clinical information (Prescribed medications’ name, dosage, frequency, route of administration, diagnosis, lab results and clinical history of patients) provided by the investigator against the British National Formulary (BNF), version 79, and Wilcock et al., guideline for prescribing drugs in ESRD (34). The committee divided the prescriptions to two major categories; 1) appropriate decision which was subcategorised to completely appropriate (Correct decision with correct choice of drug and correct application), inappropriate choice (the drug is needed, but can be replaced with a safer one), and incorrect application (correct decision and choice, but incorrect dose, frequency, or route of administration), and 2) inappropriate decision (the drug is not needed). Prescriptions with insufficient clinical information were dropped.To ensure the reliability of this approach, the Kappa statistic was used to test interrater reliability of the committee members. Value of kappa Below 0.5 was considered as bad reliability, above 0.5 and below 0.7 moderate reliability, Above 0.7 good, and above 0.8 great reliability (35).