Prevalence and clinical implications of polypharmacy and pot-entially inappropriate medication in elderly patients with heart failure:results of six months' follow-up
Man LI
Na WEI
Han-Yu SHI
Xue-Jiao JING
Xiao-Hong KAN
Hai-Qing GAO
Yun-Ling XIAO
Department of Geriatric Medicine,Qilu Hospital of Shandong University,Jinan,Shandong,China;Key Laboratory of Cardiovascular Proteomics of Shandong Province,Qilu Hospital of Shandong University,Jinan,Shandong,China
摘要：OBJECTIVES To investigate the prevalence of polypharmacy and potentially inappropriate medication(PIM)in elderly pati-ents with heart failure(HF)and their impact on readmission and mortality. METHODS We conducted a study of 274 participants aged 60 years or older with HF.The prevalence of polypharmacy(def-ined as the use of five or more medications)was calculated,and the 2019 American Geriatrics Society Beers criteria were applied to access PIMs.Medications and PIMs were characterized at admission and discharge,and changes in prescriptions during hos-pitalization were compared.The impact of polypharmacy and PIM on readmission and mortality were investigated. RESULTS The median age of this study population was 68 years old.The median number of prescribed drugs was 7 at admis-sion and 10 at discharge.At discharge,99.27％of all patients were taking five or more drugs.The incidence of composite end-point and cardiovascular readmission increased with the number of polypharmacy within 6 months.The use of guideline-direc-ted medical therapy reduced the incidence of composite endpoint events and cardiovascular readmission,while the use of non-cardiovascular medications increased the composite endpoint events.The frequency of PIMs was 93.79％at discharge.The incid-ence of composite endpoint events increased with the number of PIMs."PIMs in older adults with caution" increased cardiovas-cular readmission and "PIMs based on kidney function" increased cardiovascular mortality.Several comorbidities were associ-ated with cardiovascular mortality or non-cardiovascular readmission. CONCLUSIONS Polypharmacy and PIM were highly prevalent in elderly patients with HF,and their use was associated with an increased risk of composite endpoint events,readmission and mortality.Non-cardiovascular medications,"PIMs in older ad-ults with caution","PIMs based on kidney function" and several comorbidities were important factors associated with hospital readmission and mortality.Our findings highlight the importance of medication optimization in the management of HF in eld-erly patients.
机标关键词：clinicalheartwithelderlyfailurefollow-upimplicationsinappropriate
论文发表日期：2023-07-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：14( 495-508 )