Evidence map›Paper›PMID 33045844›Full record

Observational studyCirculation. Heart failure2020

Polypharmacy in Older Adults Hospitalized for Heart Failure.

Ozan Unlu, Emily B Levitan, Evgeniya Reshetnyak, Jerard Kneifati-Hayek, Ivan Diaz, Alexi Archambault, Ligong Chen, Joseph T Hanlon, Mathew S Maurer, Monika M Safford and 2 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Circulation. Heart failure, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 88 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
88citing papers in PubMed, 6 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

88 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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  3. Role of dietary sodium restriction in chronic heart failure: systematic review and meta-analysis.Clinical research in cardiology : official journal of the German Cardiac Society · 2024
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28 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Ozan UnluDepartment of Medicine (O.U.), Weill Cornell Medicine, New York, NY.
Emily B LevitanDepartment of Epidemiology, University of Alabama at Birmingham (E.B.L., L.C.).
Evgeniya ReshetnyakDivision of General Internal Medicine/Department of Medicine (E.R., A.A., M.M.S., P.G.), Weill Cornell Medicine, New York, NY.
Jerard Kneifati-HayekDivision of General Internal Medicine (J.K.-H.), Columbia University Medical Center, New York, NY.
Ivan DiazDepartment of Healthcare Policy and Research (I.D.), Weill Cornell Medicine, New York, NY.
Alexi ArchambaultDivision of General Internal Medicine/Department of Medicine (E.R., A.A., M.M.S., P.G.), Weill Cornell Medicine, New York, NY.
Ligong ChenDepartment of Epidemiology, University of Alabama at Birmingham (E.B.L., L.C.).
Joseph T HanlonDepartment of Medicine, University of Pittsburgh, PA (J.T.H.).
Mathew S MaurerDivision of Cardiology (M.S.M.), Columbia University Medical Center, New York, NY.
Monika M SaffordDivision of General Internal Medicine/Department of Medicine (E.R., A.A., M.M.S., P.G.), Weill Cornell Medicine, New York, NY.
Mark S LachsDivision of Geriatrics/Department of Medicine (M.L.), Weill Cornell Medicine, New York, NY.
Parag GoyalDivision of General Internal Medicine/Department of Medicine (E.R., A.A., M.M.S., P.G.), Weill Cornell Medicine, New York, NY.

Funding

VCID and Stroke in a Bi-racial National CohortU01NS041588 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CUSHMAN, MARY, HOWARD, GEORGE · 2002 to 2022
$96.0M
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 AG056446NINDS NIH HHS U01 NS041588
6 · The paper itself

Abstract

backgroundDespite potential harm that can result from polypharmacy, real-world data on polypharmacy in the setting of heart failure (HF) are limited. We sought to address this knowledge gap by studying older adults hospitalized for HF derived from the REGARDS study (Reasons for Geographic and Racial Differences in Stroke).

methodsWe examined 558 older adults aged ≥65 years with adjudicated HF hospitalizations from 380 hospitals across the United States. We collected and examined data from the REGARDS baseline assessment, medical charts from HF-adjudicated hospitalizations, the American Hospital Association annual survey database, and Medicare's Hospital Compare website. We counted the number of medications taken at hospital admission and discharge; and classified each medication as HF-related, non-HF cardiovascular-related, or noncardiovascular-related.

resultsThe vast majority of participants (84% at admission and 95% at discharge) took ≥5 medications; and 42% at admission and 55% at discharge took ≥10 medications. The prevalence of taking ≥10 medications (polypharmacy) increased over the study period. As the number of total medications increased, the number of noncardiovascular medications increased more rapidly than the number of HF-related or non-HF cardiovascular medications.

conclusionsDefining polypharmacy as taking ≥10 medications might be more ideal in the HF population as most patients already take ≥5 medications. Polypharmacy is common both at admission and hospital discharge, and its prevalence is rising over time. The majority of medications taken by older adults with HF are noncardiovascular medications. There is a need to develop strategies that can mitigate the negative effects of polypharmacy among older adults with HF.

Indexed as

PolypharmacyAgedAged, 80 and overAge FactorsCardiovascular AgentsComorbidityDrug PrescriptionsDrug Therapy, CombinationDrug UtilizationFemaleHeart FailureHospitalizationHumansMalePractice Patterns, Physicians'Prospective StudiesCardiovascular Agentsheart failurehospitalizationpolypharmacyprevalence

Identifiers

PMID33045844
PMCPMC8819498

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

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.