Evidence map›Paper›PMID 30488944›Full record

ArticleJournal of the American Geriatrics Society2019

Association Between Functional Impairment and Medication Burden in Adults with Heart Failure.

Parag Goyal, Joanna Bryan, Jerard Kneifati-Hayek, Madeline R Sterling, Samprit Banerjee, Mathew S Maurer, Mark S Lachs, Monika M Safford

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Geriatrics Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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  3. Influence of polypharmacy on patients with heart failure with preserved ejection fraction: a retrospective analysis on adverse outcomes in the TOPCAT trial.The British journal of general practice : the journal of the Royal College of General Practitioners · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Parag GoyalDivision of Cardiology, Department of Medicine, Weill Cornell Medicine, New York, New York.
Joanna BryanDivision of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York.
Jerard Kneifati-HayekDivision of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York.
Madeline R SterlingDivision of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York.
Samprit BanerjeeDepartment of Healthcare Policy and Research, Weill Cornell Medicine, New York, New York.
Mathew S MaurerCenter for Advanced Cardiac Care, Columbia University Medical Center, New York, New York.
Mark S LachsDivision of Geriatrics, Department of Medicine, Weill Cornell Medical College, New York, New York.
Monika M SaffordDivision of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York.

Funding

Impact of Polypharmacy on Rehospitalization in Older Adults with Heart FailureR03AG056446 · NIA · WEILL MEDICAL COLL OF CORNELL UNIV · PI GOYAL, PARAG · 2017 to 2018
$265k
NIA NIH HHS L30 AG060521NIA NIH HHS R03 AG056446
6 · The paper itself

Abstract

objectivesTo determine whether the number of medications taken by adults with heart failure (HF) and impairment in activities of daily living (ADL)-a subpopulation in whom the risks of a high medication burden may outweigh the benefits-differs from the number taken by those without impairment in ADLs.

designCross-sectional.

settingNational Health and Nutrition Examination Survey (NHANES; 2003-2014), a cross-sectional survey that produces national estimates of adults in the United States.

participantsAdults aged 50 and older (mean 70) with self-reported HF (N= 947; representing 4.6 million adults with HF in the United States. MEASURMENTS: We assessed ADL impairment and medication count based on self-report. ADL impairment was defined as having difficulty with or being unable to dress, feed oneself, or get in and out of bed. To determine the independent association between ADL impairment and medication count, we performed sequential Poisson multivariable regression analyses. All analyses were cross-sectional in nature and accounted for the complex survey design of NHANES.

resultsMean medication count was 7.2, and 74% of participants were taking 5 or more medications (polypharmacy). In a multivariable model, ADL impairment was not independently associated with medication count. These findings were similar for those with 3 or more hospitalizations in the prior year, declining health status, and cognitive impairment.

conclusionAfter adjusting for confounders including comorbidity, we found that adults with HF and ADL impairment take as many medications as those without ADL impairment. This suggests that providers may not sufficiently consider functional impairment when prescribing medications to adults with HF and thus may unnecessarily expose individuals to risk of adverse outcomes. J Am Geriatr Soc 67:284-291, 2019.

Indexed as

PolypharmacyActivities of Daily LivingAgedAged, 80 and overCognitive DysfunctionCross-Sectional StudiesFemaleHeart FailureHumansMaleMiddle AgedNutrition SurveysPoisson DistributionRegression AnalysisSelf ReportUnited Statesfunctional impairmentheart failurepolypharmacy

Identifiers

PMID30488944
PMCPMC6790071

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.