loading page

Characterising disease and prescribing patterns in people with heart failure and multiple chronic conditions: a single-centre descriptive cohort study
  • +9
  • schabnam saied,
  • Jameela Bahar,
  • Knievel Mashida,
  • Olivia Heron,
  • Konstantinos Prokopidis,
  • sarah gulliford,
  • Kelly Connah,
  • Debar Rasoul,
  • Asan Akpan,
  • Chukwemeka Oguguo ,
  • Lauren Walker,
  • rajiv sankaranarayanan
schabnam saied
University of Liverpool

Corresponding Author:schabnam.saied@gmail.com

Author Profile
Jameela Bahar
University of Liverpool
Author Profile
Knievel Mashida
University of Liverpool
Author Profile
Olivia Heron
University of Liverpool
Author Profile
Konstantinos Prokopidis
Aintree University Hospitals NHS Foundation Trust
Author Profile
sarah gulliford
Aintree University Hospitals NHS Foundation Trust
Author Profile
Kelly Connah
Aintree University Hospitals NHS Foundation Trust
Author Profile
Debar Rasoul
Aintree University Hospitals NHS Foundation Trust
Author Profile
Asan Akpan
Aintree University Hospitals NHS Foundation Trust
Author Profile
Chukwemeka Oguguo
Aintree University Hospitals NHS Foundation Trust
Author Profile
Lauren Walker
Aintree University Hospitals NHS Foundation Trust
Author Profile
rajiv sankaranarayanan
Aintree University Hospitals NHS Foundation Trust
Author Profile

Abstract

Introduction: Heart failure (HF) is a complex condition often accompanied by comorbidities such as renal dysfunction, diabetes mellitus (DM), chronic respiratory diseases, frailty, and anaemia, necessitating intricate management involving multiple therapeutics. Objectives: This retrospective cohort study aims to characterize prescribing patterns and identify potentially inappropriate polypharmacy in individuals with HF and multimorbidity. Methods: Data was collected from 234 HF adults with multimorbidity under the care of the HF multidisciplinary team at Liverpool University Hospital Foundation Trust (LUHFT) from January 2020 -February 2021. Results: The mean age was 71.5±13.9 and 44% were female. ACCI was 6.9±3.3, CFS was 5.5±3.2, polypharmacy burden was high at 10.2±3.9, and ACB was 1.45±0.9. ACB was higher in those with CFS≥6 vs. those with CFS<6 (1.5±1.1 vs. 1.1±0.9; p=0.02). The proportion of adults with HF on treatment for depression was 19.7%, chronic pain 35%, and chronic constipation 19.7%. Fifteen percent received oral iron instead of the appropriate intravenous iron replacement, while 17.9% of the cohort were observed to be nearing the end of their lives. Regarding PIM use, 9% were on either DAPT/anticoagulant plus anti-platelet therapy beyond 12 months of an acute coronary event. One in five patients received PPIs without clear justification. Conclusion: Adults with frailty and HF have a higher ACB. This study identifies targets for de-prescribing interventions in HF, including inappropriate PPI and DAPT/anticoagulant plus anti-platelet therapy, which are seeing in 1:5 and 1:10 adults with HF in the clinic, respectively. Tailored guidelines can aid shared decision-making, reducing drug-related complications in this group.