Polypharmacy among older individuals with heart failure: trends between 2000 and 2017 in the province of Quebec, Canada

Abstract

Objective: Pharmacological management of heart failure and comorbidities may result in polypharmacy, but there are few population-based studies that portray the use of medications over time. We aimed to describe the trends in polypharmacy and medication use in older adults with heart failure. Methods: We performed a study including all adults >65 years with heart failure between 2000 and 2017 using health administrative databases in Quebec, Canada. Medication use was ascertained by the presence of at least one claim in each year. We defined three levels of polypharmacy: ⩾10, ⩾15 and ⩾20 different medications/year, and evaluated the use of guideline-recommended and potentially inappropriate medications. We calculated age- and sex-standardized proportions of users each year. Results: The use of ⩾10, ⩾15 and ⩾20 medications increased from 62.2%, 30.6% and 12.2% in 2000 to 71.9%, 43.9% and 22.7%, respectively, in 2017. The combination of β-blocker and angiotensin-converting enzyme inhibitor (ACEI)/angiotensin II receptor blocker (ARB) was used by 30.4% of individuals in 2000 and 45.5% in 2017. ACEI/ARB users decreased from 65.8% in 2000 to 62.1% in 2017. Potentially inappropriate medication use decreased over time. Conclusion: Polypharmacy is significant among older adults with heart failure. Implications of such medication burden should be investigated.

Sex-specific medication trajectories in older adults newly diagnosed with diabetes

“…Nevertheless, this is the most used way to study polypharmacy or potentially inappropriate medications because it allows an idea of the diversity and complexity of the medications that were used in the year. 11 , 43 , 44 We also excluded the sickest people, that is, those who died and those who were admitted to long-term care. However, their consumption might have been different, since end-of-life care is associated with an increase in care, thus their inclusion would likely have generated heterogeneity.…”

POTENTIAL DRUG-DRUG INTERACTIONS OF CARDIOVASCULAR DRUGS BASED ON LITERATURE IN GERIATRIC PATIENTS WITH CONGESTIVE HEART FAILURE AT Dr. M. DJAMIL PADANG HOSPITAL

“…It is estimated that more than 40% of geriatrics aged >65 y use five or more drugs, and at least 12% use ten drugs. The increased use of drugs or polypharmacy can lead to drug interactions [9,10].…”

Psychiatric and non-psychiatric polypharmacy among older adults with schizophrenia: Trends from a population-based study between 2000 and 2016

“…Polypharmacy is a genuine concern in older individuals due to the higher risk for adverse drug events, drug-drug interactions, adherence problems, and potentially inappropriate prescriptions ( Kojima et al, 2020 ; Lin, 2020 ). In recent years, polypharmacy has been studied in different populations of older individuals with chronic conditions, such as heart failure ( Campeau Calfat et al, 2022 ), chronic obstructive pulmonary disease (COPD) ( Sirois et al, 2019b ), or diabetes ( Oktora et al, 2021 ). These studies have shown an increase in polypharmacy in the last decades.…”