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
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