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Appropriateness of Medications Prescribed to Elderly Patients with Advanced Heart Failure and Limited Life Expectancy Who Died During Hospitalization

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Abstract

Background and objectives

Drug therapy in patients with advanced heart failure and limited life expectancy may be of no benefit or even inappropriate. The aim of this study was to analyze the appropriateness of medication prescribed to patients with advanced heart failure and limited life expectancy, considering as such an expected median survival of less than 6 months.

Methods

We retrospectively reviewed data on all patients with advanced heart failure who met criteria for limited life expectancy and who died in the geriatric ward of a tertiary hospital over a four-and-a-half-year period. We analyzed treatments prescribed before admission, especially drugs used for prophylaxis or to prolong life.

Results

A total of 72 patients were included. The mean age was 85.4 years, and 52.3 % were women. Mean Charlson index was 3.2. Prophylactic medications taken by patients at admission were antiplatelets in 40 patients (55.6 %), oral anticoagulants in 17 (23.6 %), statins in 14 (19.4 %), and osteoporosis medication in nine (12.5 %). Medications taken to prolong survival were angiotensin converting enzyme inhibitors or angiotensin II receptor antagonists in 29 patients (40.3 %). Other medications were iron supplements in 19 patients (26.4 %), vitamins in two (2.8 %), and acetylcholinesterase inhibitors in two (2.8 %).

Conclusions

Our results show that patients with advanced heart failure and limited life expectancy were receiving an excessive number of prophylactic medications, drugs to prolong life, and other inappropriate treatments. These findings emphasize the need to review drug therapy in an individualized manner in elderly patients with advanced stages of heart disease and a poor prognosis.

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Acknowledgments

We thank Carolyn Newey for help with the English in this paper. No sources of funding were used to assist in carrying out this study or in the preparation of this article. The authors have no potential conflicts of interest that are directly relevant to the content of this study.

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Authors and Affiliations

  1. Geriatric Unit, Internal Medicine Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Sant Antoni Maria Claret 167, 08025, Barcelona, Spain

    Montserrat Barceló, Olga Torres & Domingo Ruiz

  2. Internal Medicine Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Sant Antoni Maria Claret 167, 08025, Barcelona, Spain

    Jordi Casademont

Authors
  1. Montserrat Barceló
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  2. Olga Torres
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  3. Domingo Ruiz
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  4. Jordi Casademont
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Correspondence to Montserrat Barceló.

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Barceló, M., Torres, O., Ruiz, D. et al. Appropriateness of Medications Prescribed to Elderly Patients with Advanced Heart Failure and Limited Life Expectancy Who Died During Hospitalization. Drugs Aging 31, 541–546 (2014). https://doi.org/10.1007/s40266-014-0183-3

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  • DOI: https://doi.org/10.1007/s40266-014-0183-3

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