Polypharmacy increasingly is a problem as treatment options expand and population ages, according to a new study, which urges pharmacists and other healthcare professionals to raise awareness of the risks associated with multiple medications.
The report in Circulation: Heart Failure noted more than half of older patients hospitalized for heart failure (HF) are discharged from the hospital with prescriptions for 10 or more medications.
“High medication burden, also known as polypharmacy, is commonly associated with adverse events and reactions,” said the study’s senior author Parag Goyal, MD, MSc, assistant professor of medicine at Weill Cornell Medicine and a geriatric cardiologist at New York-Presbyterian/Weill Cornell Medical Center. “As the treatment options for various conditions including heart failure expand and the population ages, it is becoming increasingly important to weigh the risks and possible benefits of multiple medications.”
Researchers note that, despite potential harm associated with polypharmacy, real-world data on the use of multiple medications for HF remains limited. They used participants from the REGARDS study (Reasons for Geographic and Racial Differences in Stroke) to determine the effects.
The study team focused on 558 adults aged 65 years and older with hospitalizations from diagnosed HF at 380 hospitals across the United States. Data were collected and examined from the REGARDS baseline assessment, medical charts, the American Hospital Association annual survey database, and Medicare’s Hospital Compare website.
The number of medications taken at hospital admission and discharge were counted and classified as either HF-related, non-HF cardiovascular-related, or noncardiovascular-related.
Results indicate that a very high percentage of participants—84% at admission and 95% at discharge—ended up taking five or more. Furthermore, 42% of patients at admission and 55% at discharge took 10 or more medications, researchers report.
“The prevalence of taking ≥10 medications (polypharmacy) increased over the study period,” the authors write. “As the number of total medications increased, the number of non-cardiovascular medications increased more rapidly than the number of HF-related or non-HF cardiovascular medications.”
Researchers suggest that it might be better to define polypharmacy in the HF population as taking 10 or more medications, since most patients are already taking five or more drugs.
“Polypharmacy is common both at admission and hospital discharge, and its prevalence is rising over time,” the authors point out. “The majority of medications taken by older adults with HF are non-cardiovascular medications. There is a need to develop strategies that can mitigate the negative effects of polypharmacy among older adults with HF.”