Analysis of prescription medications that may cause or exacerbate heart failure in elderly outpatients with heart failure and its influencing factors
10.3760/cma.j.cn114015-20220304-00183
- VernacularTitle:门诊老年心力衰竭患者可诱发或加重心力衰竭药物处方情况及其影响因素分析
- Author:
Tong LIU
1
;
Su SU
;
Yangxin ZHANG
;
Siqi YU
;
Suying YAN
Author Information
1. 首都医科大学药学院，北京 100069
- Publication Type:Journal Article
- Keywords:
Aged;
Heart failure;
Polypharmacy;
Potentially inappropriate medication list;
Factor analysis, statistical
- From:
Adverse Drug Reactions Journal
2022;24(11):584-590
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To understand the prescription medications that may cause or exacerbate heart failure (HF-CEPMs) in elderly outpatients with HF and analyze its influencing factors.Methods:Prescriptions for elderly patients with HF in clinic of Xuanwu Hospital, Capital Medical University between January 2016 and August 2020 were collected. According to the list of HF-CEPMs published by the American Heart Association in 2016, HF-CEPMs in prescriptions were identified. The patient′s gender, age, disease diagnosis, medical insurance, therapeutic drugs, visiting departments, physician titles, and other information are extracted from the prescription, and the use of HF-CEPMs in the prescription was descriptively analyzed. The patients were divided into HF-CEPMs group and non-HF-CEPMs group according to whether the prescription included at least one drug in the list of HF-CEPMs. The clinical characteristics, number of drugs, medical insurance, visiting departments, and professional titles of prescription physicians in patients in the 2 groups were compared, and the influencing factors of prescription containing HF-CEPMs were analyzed by multivariate logistic regression.Results:A total of 2 418 patients were enrolled, including 1 264 males (52.27%) and 1 154 females (47.73%), with a median age of 80 (65, 99) years and a median number of comorbidities 1 (0, 5). The top 3 comorbidities requiring long-term medication were hypertension (1 233 patients, 50.99%), bronchial asthma (448 patients, 18.53%) and diabetes mellitus (385 patients, 15.92%), and the median number of drugs was 5 (1, 16). Among the 2 418 patients, 254 (10.50%) used HF-CEPMs, including 142 (55.91%) males and 112 (44.09%) females. Two hundred and twenty-four patients (88.19%), 26 patients (10.24%), and 4 patients (1.57%) were treated with 1, 2, and 3 kinds of HF-CEPMs, respectively. The top 5 HF-CEPMs in drug use rates were antihypertensive drugs [4.47% (108/2 418)], pulmonary drugs [2.52% (61/2 418)], antidiabetic drugs [1.99% (48/2 418)], urological drugs [1.12% (27/2 418)], antipyretic and analgesic drugs [1.03% (25/2 418)]. Multiple logistic regression analysis showed that the number of comorbidities ≥1 (1 kind of disease: OR=3.732, 95 %CI: 2.246-6.623, P<0.001; more than 2 kinds of diseases: OR=6.054, 95 %CI: 3.624-10.788, P<0.001) and the number of prescribed drugs ≥5 ( OR=4.003, 95 %CI: 2.874-5.693, P<0.001) were independent influencing factors for prescribing HF-CEPMs. Conclusions:Antihypertensive drugs, pulmonary drugs, antidiabetic drugs, urological drugs, and antipyretic and analgesics drugs were the most common HF-CEPMs in outpatient prescriptions of elderly HF patients. The number of comorbidities and polypharmacy therapy in elderly outpatients with HF were independent influencing factors for prescribing HF-CEPMs.
