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The prevalence of potentially inappropriate medications for patients with heart failure (PIMHF) use and its association with non-cardiovascular co-morbidities in Thai patients with heart failure
  • Kittipak Jenghua
Kittipak Jenghua
University of Phayao School of Pharmaceutical Sciences
Author Profile

Abstract

Background: Several medications may worsen heart failure (HF), and they are considered as potentially inappropriate medications for patients with heart failure (PIMHF). No studies have reported the prevalence of PIMHF use and its associated factors in Thai HF patients. Objective: To determine the prevalence of PIMHF use and identify the factors associated with PIMHF use. Materials and Methods: A cross-sectional analytical study was conducted using data on HF patients obtained from the electronic medical databases (EMD) of two hospitals, including a secondary- and a tertiary-care hospital. Data collected included demographics, diagnoses, and medication items prescribed during 2016–2019. The prevalence of PIMHF use identified by the Thailand list of PIMHF was determined. Patient and clinical factors were examined for association with PIMHF use by calculating the adjusted odds ratio (aOR) and 95% confidence interval (95% CI) using a binary logistic regression analysis. Results: From the EMD, 972 and 2,888 eligible HF patients from a secondary- and a tertiary-care hospital, respectively, were included in this study. The prevalence of PIMHF use was 45.16% and 33.07% at a secondary- and a tertiary-care hospital, respectively. The PIMHF distribution appeared similar between the two study hospitals, with oral corticosteroids being the most frequently prescribed, followed by NSAIDs, COX-2 inhibitors, and thiazolidinediones. The factors associated with PIMHF use were non-cardiovascular (non-CVD) co-morbidities, including diabetes mellitus (aOR = 1.68, 95%CI = 1.42–1.99), chronic pulmonary diseases (aOR = 2.69, 95%CI = 2.07–3.48), connective tissue diseases (aOR = 7.16, 95%CI = 3.09–16.57), and cancer (aOR = 1.97, 95%CI = 1.20–3.22). Conclusion: PIMHF use was prevalent in Thai HF patients and associated with certain non-CVD co-morbidities. A careful prescription and a review of medication use should focus on HF patients with specific non-CVD co-morbidities. Keywords: Heart failure; Potentially inappropriate medications; Thailand criteria; Prevalence; Factors associated

Peer review status:ACCEPTED

01 Oct 2020Submitted to International Journal of Clinical Practice
01 Oct 2020Submission Checks Completed
01 Oct 2020Assigned to Editor
04 Oct 2020Reviewer(s) Assigned
16 Oct 2020Review(s) Completed, Editorial Evaluation Pending
16 Nov 20201st Revision Received
19 Nov 2020Submission Checks Completed
19 Nov 2020Assigned to Editor
19 Nov 2020Reviewer(s) Assigned
25 Nov 2020Review(s) Completed, Editorial Evaluation Pending
27 Nov 2020Editorial Decision: Accept