A Clinical Conundrum: The Pharmacist's Role in Evaluating Comorbid Urinary incontinence and Heart Failure

Heart failure (HF) is a complex disease to manage, and treatment strategies for older adults are complicated by the presence of comorbidities such as urinary incontinence (UI). There is a therapeutic competition that exists in the treatment of patients with both HF and UI, as many of the agents indicated for control of HF may directly exacerbate UI. A reported 80% of adults with HF are older than 65 years of age, and 50% of HF patients have UI. The prevalence of conflicting therapeutic objectives in older patients presents an opportunity for intervention by senior care pharmacists. Pharmacists are equipped to optimize medication outcomes through the provision of appropriate prescribing and deprescribing recommendations, when necessary. This provides an opportunity for shared decision making to improve patient-centered outcomes and goals of care within this population.