Changes in Medication Complexity and Post-Hospitalization Outcomes in Older Adults Hospitalized for Heart Failure

Area of Science:

• Cardiology
• Geriatrics
• Pharmacology

Background:

• Medication regimen complexity is a potential risk factor for adverse outcomes in older adults with heart failure.
• Optimizing guideline-directed medical therapy during heart failure hospitalization often increases medication complexity.

Purpose of the Study:

• To investigate the association between increased medication regimen complexity post-heart failure hospitalization and subsequent adverse outcomes.

Main Methods:

• Retrospective cohort study of adults aged ≥65 hospitalized for heart failure (2003-2014).
• Assessed changes in medication count (Δcount) and Medication Regimen Complexity Index (ΔMRCI) from admission to discharge.
• Primary outcome: composite of 90-day all-cause readmission or mortality.

Main Results:

• Nearly 75% of patients experienced increased medication regimen complexity; 60% had increased medication count.
• Neither increased MRCI nor medication count was associated with 90-day readmission or mortality.
• Higher complexity was more common in female and Black patients, and associated with comorbidities and non-home discharge.

Conclusions:

• Increased medication regimen complexity is frequent after heart failure hospitalization but not linked to worse 90-day outcomes.
• Clinicians can focus on optimizing heart failure medication regimens without undue concern for complexity.
• These findings offer reassurance for managing complex medication regimens in heart failure patients.