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Polypharmacy in patients with chronic heart failure

Session Poster Session 3

Speaker Mihnea Alexandru Gaman

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure: Pharmacotherapy
  • Session type : Poster Session

Authors : MA Gaman (Bucharest,RO), EC Dobrica (Bucharest,RO), MA Cozma (Bucharest,RO), AM Gaman (Craiova,RO), CC Diaconu (Bucharest,RO)

Authors:
MA Gaman1 , EC Dobrica1 , MA Cozma1 , AM Gaman2 , CC Diaconu1 , 1University of Medicine and Pharmacy Carol Davila - Bucharest - Romania , 2University of Medicine and Pharmacy of Craiova, Pathophysiology - Craiova - Romania ,

Citation:

Background: Ageing is associated with an increased number of comorbidities that frequently require medical treatment. Since the incidence of chronic heart failure (HF) is age-related, it is more likely that HF patients will be subjected to polypharmacy. However, polypharmacy often involves potentially dangerous drug-drug and food-drug interactions that complicate the management of both HF and other possible afflictions. Purpose: Our aim was to investigate the use of polypharmacy in HF patients. Methods: We conducted a retrospective, observational study on patients referred between January and February 2018 to the Internal Medicine Department of an emergency hospital in Romania. Patients were identified by a database search of diagnostic codes of discharge diagnoses. Patient characteristics and medical prescriptions were retrieved from medical records. Student t-test was used to assess differences between groups. Results: The study group (74.02±10.62 years, range 46-92 years) included 55 heart failure patients: 26 women (47.30%) and 29 men (52.70%). The control group (64.48±13.62 years, range 22-93 years) included 153 non-HF patients: 75 women (49.02%) and 78 men (50.98%). In HF patients, the number of comorbidities per-patient was 10.69±3.26 (vs. 7.88±3.27 in controls), the number of prescribed drugs at discharge was 7.93±1.97 per-patient (vs. 5.83±2.80 in controls) and the number of drug-to-drug interactions was 9.15±5.41 per-patient (vs. 4.80±5.02 in controls). 98.18% (54 patients) of the study group was at risk for at least one potentially harmful interaction vs. 79.08% (121 patients) in the control group. In HF patients, age correlated positively with the number of comorbidities, but negatively with the number of drugs, drug-drug and food-drug interactions. Conclusions: Chronic HF patients were prescribed more drugs at discharge and had a higher number of potentially harmful drug-drug or food-drug interactions vs. non-HF patients, as reinforced by our data. Chronic HF patients also had more comorbidities vs. non-HF subjects. Polypharmacy management must be taken into consideration by the clinician when treating chronic HF patients in order reduce drug burden and avoid unnecessary medication.

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