Abstract | BACKGROUND: There is growing concern at the nature and extent of polypharmacy in heart failure (HF), which may be associated with increased drug interactions, adverse drug effects and a poor understanding of and compliance with therapy. AIMS: METHODS: We analysed the medication profiles of 91 consecutive patients with an emergency admission for HF to our institution on admission and discharge. The numbers of inappropriate medicines, inappropriate dosages and omitted medicines according to guidelines were recorded. Medication profiles were analysed for potential drug- drug, drug-liver and drug-kidney interactions using standard criteria. RESULTS: In the study population, average age 71.1+/-10.4 years, 65.9% were male, 68.1% had left ventricular systolic dysfunction and the average ejection fraction on transfer to the specialist HF service was 38+/-13%. A total of 66 inappropriate medicines, 107 omitted medicines and 37 inappropriate dosage regimens were identified in the cohort on admission. These figures had dropped to 31, 33 and 19, respectively, on discharge, with per patient averages decreasing significantly (all P<0.0001). However, polypharmacy and potential drug interactions increased by 33% and 62%, respectively, from admission to discharge (P<0.0001) as did drug-kidney interactions and drug-liver interactions. Only ischemic aetiology and hypercholesterolaemia predicted polypharmacy in this cohort on discharge, whereas age, sex, renal function and heart failure type did not. CONCLUSIONS:
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Authors | Mark Ledwidge, Bronagh Travers, Mary Ryder, Enda Ryan, Kenneth McDonald |
Journal | European journal of heart failure
(Eur J Heart Fail)
Vol. 6
Issue 2
Pg. 235-43
(Mar 01 2004)
ISSN: 1388-9842 [Print] England |
PMID | 14984732
(Publication Type: Journal Article)
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Topics |
- Aged
- Drug Interactions
- Emergency Medical Services
- Female
- Heart Failure
(drug therapy, economics, physiopathology)
- Humans
- Male
- Polypharmacy
- Treatment Outcome
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