Association of Potentially Inappropriate Medications With All-Cause Mortality in the Elderly Acute Decompensated Heart Failure Patients: Importance of Nonsteroidal Anti-Inflammatory Drug Prescription

Sunaga, Tomiko; Yokoyama, Azusa; Nakamura, Shoko; Miyamoto, Nagisa; Watanabe, Saki; Tsujiuchi, Miki; Nagumo, Sakura; Nogi, Ayaka; Maezawa, Hideyuki; Mizukami, Takuya; Ebato, Mio; Suzuki, Hiroshi; Nakamura, Akihiro; Watanabe, Tôru; Sasaki, Takeshi

doi:10.14740/cr1078

Cited by 10 publications

(12 citation statements)

References 33 publications

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“…The included studies were all observational in nature and consisted of 7 (41.2%) cohort studies [12][13][14][15][16][17][18], 13 (58.8%) cross-sectional studies [19][20][21][22][23][24][25][26][27][28][29][30][31], and 2 studies were secondary analyses from previous randomized controlled trial datasets [32,33]. In total, 70,695 heart failure patients were included in the studies.…”

Section: Resultsmentioning

confidence: 99%

“…Studies were across a range of care settings: 8 from outpatients clinics [12,13,22,23,30,[32][33][34], 11 from hospital inpatients [14-18, 25-29, 31] and 1 from each general population [21], nursing homes [24] and primary care [19]. Studies were from across the globe: 7 from USA [12,21,22,30,31,33,34]; 3 from Italy [16,18,27]; 2 from the UK [14,19], Japan [25,29] and Australia [13,26]; 1 each from of Spain [23], Poland [24], Ethiopia [15], Greece [17] and Slovakia [28] and 1 from north and south America combined [32].…”

Section: Resultsmentioning

confidence: 99%

“…A study by Verdiani et al [27] looked at the European Society of Cardiology definition of heart failure and included all 3 groups [8]. Lien et al [14] Michalik et al [24] and Unlu et al [31] included all heart failure, Taylor et al [26] and Sunaga et al [29] included all decompensated heart failure admitted to hospital, and the remaining 6 studies did not specify the heart failure cohort included [15-17, 25, 28, 33]. See Table 2 for full data extraction.…”

Section: Resultsmentioning

confidence: 99%

“…Where polypharmacy was defined as 5 or more medicines, with 11 out of 13 of these studies finding a prevalence of ≥ 60%. Polypharmacy prevalence was 66.3% [29] to 74% [23,33] in patients taking six or more medications. Verdiani et al showed that 57% of patients had eight or more medication classes [27] where Sganga et al [18] showed 72.4% to be taking eight or more and Knafl et al having 60.6% taking nine or more medications [22].…”

Section: Prevalence Of Polypharmacymentioning

confidence: 99%

“…No standardised definition was used consistently across all the studies. The most commonly used definition was that of [18,27] and three used a definition of six or more medications [23,28,29]. Knafl et al [22] chose greater or equal to nine medication as the polypharmacy definition.…”

Section: Definition Of Polypharmacymentioning

confidence: 99%

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Polypharmacy definition and prevalence in heart failure: a systematic review

et al. 2021

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Polypharmacy and heart failure are becoming increasingly common due to an ageing population and the rise of multimorbidity. Treating heart failure necessitates prescribing of multiple medications, in-line with national and international guidelines predisposing patients to polypharmacy. This review aims to identify how polypharmacy has been defined among heart failure patients in the literature, whether a standard definition in relation to heart failure could be identified and to describe the prevalence. The Healthcare Database Advanced Search (HDAS) was used to search EMBASE, MEDLINE, PubMed, Cinahl and PsychInfo from inception until March 2021. Articles were included of any design, in patients ≥ 18 years old, with a diagnosis of heart failure; that explicitly define and measure polypharmacy. Data were thereafter extracted and described using a narrative synthesis approach. A total of 7522 articles were identified with 22 meeting the inclusion criteria. No standard definition of polypharmacy was identified. The most common definition was that of " ≥ 5 medications." Polypharmacy prevalence was high in heart failure populations, ranging from 17.2 to 99%. Missing or heterogeneous methods for defining heart failure and poor patient cohort characterisation limited the impact of most studies. Polypharmacy, most commonly defined as ≥ 5 medications, is highly prevalent in the heart failure population. There is a need for an internationally agreed definition of polypharmacy, allowing accurate review of polypharmacy issues. Whether an arbitrary numerical cut-off is a suitable definition, rather than medication appropriateness, remains unclear. Further studies are necessary to understand the relationship between polypharmacy with specific types of heart failure and related comorbidities.

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