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Risk Assessment of Polypharmacy in Elderly Patients with Chronic Heart Failure
J. Kor. Soc. Health-syst. Pharm. 2021;38:30-40
Published online February 28, 2021;  https://doi.org/10.32429/jkshp.2021.38.1.003
© 2021 Korean Society of Health-System Pharmacists

Hyun Jun Gu and Eyn Young Kwon

Department of Pharmacy, Seoul St. Mary’s Hospital, The Catholic University of Korea 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
Correspondence to: †교신저자 구현준 Tel:02-2258-2553 E-mail:guhj@cmcnu.or.kr
Received September 25, 2020; Revised October 21, 2020; Accepted December 16, 2020.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background and objective : Elderly patients with chronic heart failure have polypharmacy to control chronic heart failure and comorbidities. Polypharmacy may increase the use of inappropriate medications and the risk of adverse drug reactions (ADRs). The purpose of this study was to evaluate the causality between polypharmacy and ADRs in elderly patients with chronic heart failure.
Methods : This study included chronic heart failure outpatients aged 65 and older who visited our facility from January 1 to June 30, 2018. The total number of medications, potentially inappropriate medications (PIMs), and suspected ADRs were analyzed. An analysis was conducted to determine which factors influenced the occurrence of suspected ADR.
Results : The mean age of the 286 patients with one or more comorbidities was 78.6 years (SD 7.2), and 64.3% were female. There were 76 patients in the group taking 1 – 4 medications, 152 in the group taking 5 – 9 medications, and 58 patients in the group taking 10 or more. There were 149 patients in the group not taking PIM, 86 in the group taking one PIM, and 51 in the group taking two or more. There were 129 suspected ADR cases. The number of medications was the factor influencing suspected ADRs. The odds ratio of suspected ADRs was 3.87 in the 5 – 9 medications group (95% CI: 1.79 – 8.38, p=0.0006) and 6.48 in the 10 or more group (95% CI: 2.73 –15.41, p< 0.0001) compared to the 1 – 4 medications group.
Conclusion : In outpatients 65 years or older with chronic heart failure, polypharmacy increased the risk of suspected ADRs. Medication reconciliation by the pharmacist focused on polypharmacy and PIM will reduce ADRs, and lead to safe and appropriate drug therapy.
Keywords : CHF (Chronic Heart Failure), Beers Criteria, Polypharmacy, ADR (Adverse Drug Reaction)


February 2021, 38 (1)