Patient harm from cardiovascular medications.

Area of Science:

• Pharmacovigilance
• Patient Safety
• Geriatric Medicine

Background:

• Medication harm significantly impacts patient outcomes and healthcare systems.
• Cardiovascular (CV) medications are increasingly recognized as a major source of harm, yet often overlooked in 'high-risk' classifications.
• Existing safety frameworks like APINCH do not consistently identify CV medications as high-risk.

Purpose of the Study:

• To determine the scale and nature of medication harm attributed to CV medications.
• To rank CV medications against other drug classes concerning harm incidence.
• To investigate the specific types of harm and implicated CV drugs.

Main Methods:

• A narrative review of adult medication harm literature from PubMed and CINAHL databases.
• Inclusion of studies measuring the incidence of medication harm.
• Analysis of harm caused by CV medications across four healthcare settings.

Main Results:

• CV medications accounted for approximately 20% of medication harm, rising to 50% in older populations.
• CV medications were consistently ranked among the top five causes of harm.
• Preventable harm from CV medications, particularly blood pressure and anti-arrhythmic drugs, led to kidney injury, electrolyte imbalance, and hypotension.

Conclusions:

• CV medications are a significant cause of medication harm, particularly in the elderly, necessitating targeted harm reduction strategies.
• Healthcare professionals should prioritize careful prescribing and regular review of CV medications.
• Incorporating 'C' for CV medications into the APINCH acronym is proposed to enhance awareness and safety.