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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
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Complex and Potentially Harmful Medication Patterns in Heart Failure with Preserved Ejection Fraction.
Lina M Brinker1, Matthew C Konerman2, Pedram Navid3
1Department of Internal Medicine, University of Michigan, Ann Arbor.
The American Journal of Medicine
|August 22, 2020
Summary
Complex medication regimens are common in heart failure with preserved ejection fraction (HFpEF). A study found high rates of polypharmacy, inappropriate medications, and therapeutic competition in HFpEF patients, highlighting the need for better care strategies.
Area of Science:
- Cardiology
- Pharmacology
- Geriatrics
Background:
- Complex medication regimens in heart failure with preserved ejection fraction (HFpEF) increase adverse drug event risk.
- Characterizing medication complexity in HFpEF is crucial for patient safety.
- Dedicated HFpEF programs offer unique insights into medication management challenges.
Purpose of the Study:
- To determine the prevalence of polypharmacy, potentially inappropriate medications (PIMs), and therapeutic competition in HFpEF patients.
- To analyze medication complexity within a specialized HFpEF clinic.
- To identify risks associated with current medication practices in HFpEF.
Main Methods:
- Retrospective chart review of 231 HFpEF patients from July 2016 to September 2019.
- Defined polypharmacy as ≥10 medications.
- Identified PIMs using AHA guidelines, Beers Criteria, and geriatric syndrome associations.
- Assessed therapeutic competition between conditions and medications.
Main Results:
- Polypharmacy prevalence was 74%.
- 100% of patients were prescribed potentially inappropriate medications.
- 81% of patients had competing conditions, with 49% on medications causing therapeutic competition.
Conclusions:
- Polypharmacy, PIMs, and therapeutic competition are highly prevalent in HFpEF.
- Current medication regimens pose significant risks to HFpEF patients.
- Patient-centered strategies are urgently needed to manage complex medication regimens in HFpEF.
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