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Background Several medications may worsen heart failure (HF), and they are considered as potentially inappropriate medications for patients with heart failure (PIMHF). No studies reported the prevalence of PIMHF use and its associated factors in Thai HF patients. Objective To determine the prevalence of PIMHF use and identify factors associated with PIMHF use. Material and Method A cross‐sectional study was conducted using data on HF patients obtained from the electronic medical databases (EMDs) of two hospitals, including a secondary and a tertiary care hospital. Data collected included demographics, diagnoses and medications prescribed during 2016‐2019. The prevalence of PIMHF use identified by the Thailand list of PIMHF was determined. Patient and clinical factors were examined whether they were associated with PIMHF use by calculating the adjusted odds ratio (aOR) and 95% confidence interval (95% CI) using a binary logistic regression analysis. Results From the EMD, 972 and 2888 eligible HF patients from a secondary and a tertiary care hospital, respectively, were included in this study. The prevalence of PIMHF use was 45.16% and 33.07% at a secondary and a tertiary care hospital, respectively. Factors associated with PIMHF use were HFpEF (aOR = 1.68, 95% CI = 1.39‐2.03), diabetes mellitus (DM) (aOR = 1.66, 95% CI = 1.35‐2.05), renal failure (RF) (aOR = 1.49, 95% CI = 1.21‐1.84), chronic pulmonary diseases (CPD) (aOR = 2.41, 95% CI = 1.74‐3.34), connective tissue diseases (CTD) (aOR = 5.21, 95% CI = 2.17‐12.49), and cancer (aOR = 2.57, 95% CI = 1.36‐4.86). Conclusion PIMHF use according to the Thailand list of PIMHF was prevalent in Thai HF patients and associated with HFpEF, DM, RF, CPD, CTD and cancer.

Background: Several medications may worsen heart failure (HF), and they are considered as potentially inappropriate medications for patients with heart failure (PIMHF). No studies have reported the prevalence of PIMHF use and its associated factors in Thai HF patients. Objective: To determine the prevalence of PIMHF use and identify the factors associated with PIMHF use. Materials and Methods: A cross-sectional analytical study was conducted using data on HF patients obtained from the electronic medical databases (EMD) of two hospitals, including a secondary-and a tertiary-care hospital. Data collected included demographics, diagnoses, and medication items prescribed during 2016-2019. The prevalence of PIMHF use identified by the Thailand list of PIMHF was determined. Patient and clinical factors were examined for association with PIMHF use by calculating the adjusted odds ratio (aOR) and 95% confidence interval (95% CI) using a binary logistic regression analysis. Results: From the EMD, 972 and 2,888 eligible HF patients from a secondary-and a tertiary-care hospital, respectively, were included in this study. The prevalence of PIMHF use was 45.16% and 33.07% at a secondary-and a tertiary-care hospital, respectively. The PIMHF distribution appeared similar between the two study hospitals, with oral corticosteroids being the most frequently prescribed, followed by NSAIDs, COX-2 inhibitors, and thiazolidinediones. The factors associated with PIMHF use were non-cardiovascular (non-CVD) co-morbidities, including diabetes mellitus (aOR = 1.68, 95%CI = 1.42-1.99), chronic pulmonary diseases (aOR = 2.69, 95%CI = 2.07-3.48), connective tissue diseases (aOR = 7.16, 95%CI = 3.09-16.57), and cancer (aOR = 1.97, 95%CI = 1.20-3.22). Conclusion: PIMHF use was prevalent in Thai HF patients and associated with certain non-CVD co-morbidities. A careful prescription and a review of medication use should focus on HF patients with specific non-CVD co-morbidities.

Background: Thailand have developed a list of potentially inappropriate medications for patients with heart failure (PIMHF). However, its association with clinical outcomes has not been evaluated in real-world clinical practice. Objective: To examine the association between the prescription of any PIMHF and hospitalization from heart failure (HF). Methods: A 1:1 matched case-control study was conducted. Data on HF patients visiting the study hospitals during 2017-2019 were obtained from the electronic medical record database. Patients with a history of first hospitalization due to HF and those with a history of outpatient department visits or non-HF hospitalization were defined as cases and controls, respectively. The association of hospitalization from HF with the prescription of any PIMHF was expressed as the adjusted odds ratio (aOR) and 95% confidence interval (95%CI), calculated using a conditional logistic regression (CLR) model. Results: After matching, 1,603 pairs of case and control were generated for the analysis. In total, 21 of 47 PIMHF were found to have been prescribed. Compared with the reference group of patients not prescribed any of the 21 PIMHF, those who had been prescribed a PIMHF had an aOR of 1.47 [95%CI 1.02:2.13]. NSAIDs/COX-2 inhibitors, oral short-acting beta-2 agonists, medications that promote fluid overload, and medications that elevate blood pressure were the four medication classes associated with the increased risk of hospitalization from HF (aOR = 2.64, [95%CI 1.30:5.38], aOR = 4.87, [95%CI 1.17:20.29], aOR = 1.50, [95%CI 1.01:2.22], and aOR = 2.51, [95%CI 1.26:4.99], respectively). Conclusions: The prescription of any of the 21 PIMHF found to have been prescribed in this study may increase the risk of hospitalization from HF. The Thai PIMHF list may be used in pharmacy practice as an assessment tool for the appropriate use of medication in HF patients.