Prescriptions for Potentially Inappropriate Medications from the Beers Criteria Among Older Adults Hospitalized for Heart Failure

Authors

Diana Jaber, School of Medicine & Health Sciences, George Washington University, Washington, DC.
Fabian Vargas, Department of Medicine, Weill Cornell Medicine, New York, New York.
Linh Nguyen, School of Medicine, University of Colorado, Aurora, Colorado.
Joanna Ringel, Department of Medicine, Weill Cornell Medicine, New York, New York.
Kate Zarzuela, Department of Medicine, Weill Cornell Medicine, New York, New York.
Mahad Musse, Department of Medicine, Weill Cornell Medicine, New York, New York.
Min Ji Kwak, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center, Houston, Texas.
Emily B. Levitan, Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama.
Mathew S. Maurer, Department of Medicine, Columbia University Irving Medical Center, New York, New York.
Mark S. Lachs, Department of Medicine, Weill Cornell Medicine, New York, New York.
Monika M. Safford, Department of Medicine, Weill Cornell Medicine, New York, New York.
Parag Goyal, Department of Medicine, Weill Cornell Medicine, New York, New York. Electronic address: pag9051@med.cornell.edu.

Document Type

Journal Article

Publication Date

6-1-2022

Journal

Journal of cardiac failure

Volume

28

Issue

6

DOI

10.1016/j.cardfail.2021.11.014

Keywords

PIMs; adverse reactions

Abstract

BACKGROUND: We sought to better understand patterns of potentially inappropriate medications (PIMs) from the Beers criteria among older adults hospitalized with heart failure (HF). This observational study of hospitalizations was derived from the geographically diverse REasons for Geographic and Racial Differences in Stroke cohort. METHODS AND RESULTS: We examined participants aged 65 years and older with an expert-adjudicated hospitalization for HF. The Beers criteria medications were abstracted from medical records. The prevalence of PIMs was 61.1% at admission and 64.0% at discharge. Participants were taking a median of 1 PIM (interquartile range [IQR] 0-1 PIM) at hospital admission and a median of 1 PIM (IQR 0-2 PIM) at hospital discharge. Between admission and discharge, 19.1% of patients experienced an increase in the number of PIMs, 15.1% experienced a decrease, and 37% remained on the same number between hospital admission and discharge. The medications with the greatest increase from admission to discharge were proton pump inhibitors (32.6% to 38.6%) and amiodarone (6.2% to 12.2%). The strongest determinant of potentially harmful prescribing patterns was polypharmacy (relative risk 1.34, 95% confidence interval 1.16-1.55, P < .001). CONCLUSIONS: PIMs are common among older adults hospitalized for HF and may be an important target to improve outcomes in this vulnerable population.

APA Citation

Jaber, Diana; Vargas, Fabian; Nguyen, Linh; Ringel, Joanna; Zarzuela, Kate; Musse, Mahad; Kwak, Min Ji; Levitan, Emily B.; Maurer, Mathew S.; Lachs, Mark S.; Safford, Monika M.; and Goyal, Parag, "Prescriptions for Potentially Inappropriate Medications from the Beers Criteria Among Older Adults Hospitalized for Heart Failure" (2022). GW Authored Works. Paper 1196.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/1196

Department

School of Medicine and Health Sciences Student Works