Prescription for trouble: Most heart failure patients leave hospital with 10+ medications

DALLAS, Texas — For many older Americans, it can be a challenge keeping track of all the prescription drugs they take. A new study finds some are taking a staggering number of medications. For those at risk for heart failure, researchers say some of those drugs might be making their problems worse.

A report by the American Heart Association reveals more than half of older heart failure patients leave the hospital with at least 10 prescription medications in their name. The study of 558 adults over the age of 65 finds a staggering 84 percent took five or more drugs before entering a hospital and 42 percent were taking over 10.

After the group’s hospital stay, it turns out doctors prescribed even more medications for these seniors. Nearly every patient (95%) had been prescribed at least five medications and 55 percent were taking over 10 after discharge.

“High medication burden, also known as polypharmacy, is commonly associated with adverse events and reactions,” says study senior author Parag Goyal in a media release. “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.”

What are all these drugs even doing?

The study focuses on American seniors on Medicare hospitalized between 2003 and 2014. The entire group was also part of the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study; monitoring the health of 30,000 participants since 2003.

Researchers reveal that polypharmacy practices have only gone up since the beginning of the study. While 41 percent of seniors hospitalized from 2003 to 2006 had over 10 medications, that number skyrocketed to 68 percent between 2011 and 2014.

Study authors broke these drugs into different categories according to the conditions they treat. Those included heart failure medications; aspirin and statin drugs for other heart conditions; and non-heart-related prescriptions (for illnesses like kidney disease and Type 2 diabetes).

Despite being hospitalized for heart trouble, study authors find most of the prescriptions seniors were taking don’t treat the heart at all.

“Some of these drugs may be appropriate. However, our prior work has shown that many patients are discharged with prescriptions for medications that can worsen heart failure,” Goyal, a geriatric cardiologist at New York-Presbyterian/Weill Cornell Medical Center warns.

Weeding out old and unneeded prescriptions

The study recommends doctors, especially those dealing with heart failure patients, begin paying closer attention to the long lists of drugs some seniors are on. By adjusting and cutting the ones no longer relevant to their health problems, physicians can cut down on potential side-effects.

“This supports the ongoing need for improved and routine medication review processes prior to hospital discharge, and particularly in the immediate post-discharge period where the risk of hospital readmission is particularly high,” Goyal adds.

“Our findings support the need to tailor decisions related to medication prescribing for each patient while considering their overall health status. The key to managing polypharmacy is medication review during each appointment. With regular review, the hope is that the right medications – where the possible benefit outweighs the risks – will be started or continued, and if the risks outweigh possible benefits, those medications are discontinued.”

Getting better at treating heart failure

Goyal’s team says the study focuses on data gathered before several new heart failure treatments became available. This raises the chances even more seniors are currently living with over 10 medication bottles on their tables at home.

“Advances in medicine have provided patients with an increasing number of treatment options. This is a good thing. However, it is important to also consider the negative consequences of more medications prescribed for each patient,” the director of the Heart Failure with Preserved Ejection Fraction Program at Weill Cornell Medicine concludes.

The study appears in the AHA journal Circulation: Heart Failure.

Like studies? Follow us on Facebook!

Leave a Reply

Your email address will not be published.