دورية أكاديمية
أعرض في EDS

Use of Medicines that May Exacerbate Heart Failure in Older Adults: Therapeutic Complexity of Multimorbidity.

التفاصيل البيبلوغرافية
العنوان: Use of Medicines that May Exacerbate Heart Failure in Older Adults: Therapeutic Complexity of Multimorbidity.
المؤلفون: Caughey GE; Discipline of Pharmacology, Adelaide Medical School, University of Adelaide, North Terrace, Adelaide, 5001, Australia. gillian.caughey@adelaide.edu.au.; School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, 5001, Australia. gillian.caughey@adelaide.edu.au.; Clinical Pharmacology, Royal Adelaide Hospital, North Terrace, Adelaide, 5001, Australia. gillian.caughey@adelaide.edu.au., Shakib S; Discipline of Pharmacology, Adelaide Medical School, University of Adelaide, North Terrace, Adelaide, 5001, Australia.; Clinical Pharmacology, Royal Adelaide Hospital, North Terrace, Adelaide, 5001, Australia., Barratt JD; School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, 5001, Australia., Roughead EE; School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, 5001, Australia.
المصدر: Drugs & aging [Drugs Aging] 2019 May; Vol. 36 (5), pp. 471-479.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Adis, Springer International Country of Publication: New Zealand NLM ID: 9102074 Publication Model: Print Cited Medium: Internet ISSN: 1179-1969 (Electronic) Linking ISSN: 1170229X NLM ISO Abbreviation: Drugs Aging Subsets: MEDLINE
أسماء مطبوعة: Publication: Auckland : Adis, Springer International
Original Publication: Mairangi Bay, Auckland, N.Z. : Adis International, c1991-
مواضيع طبية MeSH: Multimorbidity*, Drug-Related Side Effects and Adverse Reactions/*epidemiology , Heart Failure/*epidemiology, Aged ; Aged, 80 and over ; Australia/epidemiology ; Drug-Related Side Effects and Adverse Reactions/etiology ; Female ; Heart Failure/drug therapy ; Hospitalization/statistics & numerical data ; Humans ; Male ; Patient Discharge/statistics & numerical data ; Prevalence ; Retrospective Studies
مستخلص: Background: Multimorbidity is common in older patients with heart failure (HF), complicating therapeutic management and increasing the risk of harm.
Objective: This study sought to examine the prevalence of medicines for the treatment of comorbid conditions potentially associated with harm in older people, before and after HF hospitalization.
Methods: A retrospective cohort study of older people hospitalized with a primary diagnosis of HF over a 12-month period was conducted using administrative health claims data from the Department of Veterans' Affairs (DVA) Australia. We examined the prevalence of medicines that may exacerbate or worsen HF as defined by the American Heart Association (AHA) and Australian HF clinical guidelines, in the 30 days prior and 120 days before and after discharge for HF.
Results: A total of 4069 older adults were hospitalized for HF during the study period; almost 60% (n = 2435) received at least one medicine associated with an increased risk of harm before hospitalization, with the majority (66.7%, n = 1623) dispensed in the 30 days prior. A small but significant reduction after hospitalization was observed, but 56% (n = 1638) received at least one of these medicines after hospitalization (p = 0.001). Over one-quarter received two or more medicines before hospitalization, and this only reduced to 22% post-hospitalization (p < 0.0001).
Conclusions: Little change in the prescribing of potentially harmful medicines for HF was observed; 56% of older adults received at least one following hospitalization for HF, highlighting the therapeutic complexity of multimorbidity in HF. Use of the AHA list to facilitate identification of potentially harmful medicines, followed by prioritization of treatment goals and appropriate risk mitigation are needed to facilitate reduction in hospitalization for patients with HF with multimorbidity.
References: Drugs Aging. 2011 Jul 1;28(7):575-81. (PMID: 21721601)
Intern Med J. 2014 Nov;44(11):1117-23. (PMID: 24942781)
Circulation. 2010 Nov 2;122(18):1806-14. (PMID: 20956211)
Circ Heart Fail. 2016 Sep;9(9):. (PMID: 27618853)
Circ Heart Fail. 2013 Jan;6(1):76-82. (PMID: 23230308)
Circulation. 2005 Jan 18;111(2):179-85. (PMID: 15642765)
BMC Geriatr. 2017 Oct 10;17(1):230. (PMID: 29017448)
Circ Heart Fail. 2013 May;6(3):606-19. (PMID: 23616602)
Eur J Heart Fail. 2017 Nov;19(11):1414-1423. (PMID: 28463464)
Aust N Z J Public Health. 2009 Apr;33(2):126-30. (PMID: 19413854)
JAMA. 2013 Jan 23;309(4):355-63. (PMID: 23340637)
J Am Coll Cardiol. 2014 Apr 1;63(12):1123-1133. (PMID: 24491689)
J Am Coll Cardiol. 2003 Oct 1;42(7):1226-33. (PMID: 14522486)
Circulation. 2016 Aug 9;134(6):e32-69. (PMID: 27400984)
Am J Geriatr Cardiol. 2005 May-Jun;14(3):134-41. (PMID: 15886539)
Am J Med. 2011 Feb;124(2):136-43. (PMID: 21295193)
J Am Coll Cardiol. 2009 Oct 27;54(18):1695-702. (PMID: 19850209)
Eur J Heart Fail. 2010 Apr;12(4):367-74. (PMID: 20197265)
PLoS One. 2018 May 8;13(5):e0196122. (PMID: 29738540)
JAMA. 2004 Mar 17;291(11):1358-67. (PMID: 15026403)
Circulation. 2012 Jul 24;126(4):501-6. (PMID: 22825412)
PLoS One. 2009;4(2):e4439. (PMID: 19209224)
J Clin Epidemiol. 2014 Nov;67(11):1242-50. (PMID: 25216898)
Circulation. 2013 Oct 15;128(16):e240-327. (PMID: 23741058)
Ann Intern Med. 2017 Feb 7;166(3):191-200. (PMID: 28055049)
Eur J Clin Pharmacol. 2013 Mar;69(3):319-26. (PMID: 22965651)
J Card Fail. 2017 Aug;23(8):628-651. (PMID: 28461259)
JAMA. 2010 May 5;303(17):1716-22. (PMID: 20442387)
Med J Aust. 2018 Oct 15;209(8):363-369. (PMID: 30067937)
Circ Heart Fail. 2009 Sep;2(5):424-8. (PMID: 19808372)
تواريخ الأحداث: Date Created: 20190316 Date Completed: 20191010 Latest Revision: 20200309
رمز التحديث: 20240628
DOI: 10.1007/s40266-019-00645-0
PMID: 30875020
قاعدة البيانات: MEDLINE
الوصف
تدمد:1179-1969
DOI:10.1007/s40266-019-00645-0