Evidence map›Paper›PMID 35761118›Full record

SynthesisDrugs & aging2022

The Prevalence of Adverse Drug Reactions and Adverse Drug Events from Heart Failure Medications in Frail Older Adults: A Systematic Review.

Mai H Duong, Danijela Gnjidic, Andrew J McLachlan, Marissa A Sakiris, Parag Goyal, Sarah N Hilmer

Open access · hybridAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Drugs & aging, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 4 pooled it
3.0field-weighted citation impact, top 9% of its field
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

20 citing papers in PubMed, 4 syntheses or guidelines pooled it, 26 citations in OpenAlex.

  1. Pooled it
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  6. Review
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  11. [Frailty and pharmacotherapy].Innere Medizin (Heidelberg, Germany) · 2025
    Review
  12. Article
  13. Drugs and Healthy Aging.Drugs & aging · 2025
    Review
  14. Article
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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

6 authors at 3 institutions in 2 countries.

Mai H DuongFaculty of Medicine and Health, Northern Clinical School, The University of Sydney, Sydney, NSW, Australia. mai.duong@sydney.edu.au.ORCID http://orcid.org/0000-0002-6764-3233
Danijela GnjidicFaculty of Medicine and Health, Sydney Pharmacy School, The University of Sydney, Sydney, NSW, Australia.
Andrew J McLachlanFaculty of Medicine and Health, Sydney Pharmacy School, The University of Sydney, Sydney, NSW, Australia.
Marissa A SakirisDepartment of Pharmacy, Royal North Shore Hospital, Sydney, NSW, Australia.
Parag GoyalWeill Cornell Medicine, New York, NY, USA.
Sarah N HilmerFaculty of Medicine and Health, Northern Clinical School, The University of Sydney, Sydney, NSW, Australia.
The University of Sydney · AUCornell University · USRoyal North Shore Hospital · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionFrailty is highly prevalent in heart failure populations and a major risk factor for adverse drug reactions (ADRs) and adverse drug events (ADEs). This review aimed to describe the prevalence, causality and severity of ADRs or ADEs from heart failure medications among frail compared with non-frail older adults.

methodsA systematic search of CENTRAL, MEDLINE, Embase, Ageline, CINAHL, International Pharmaceutical Abstracts, PsychInfo, Scopus, registries and citations prior to 18 May 2021 was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist. Risk of bias and quality of evidence were assessed. Eligible studies included randomised controlled trials (RCTs) and observational studies of people diagnosed with heart failure, aged ≥ 65 years, with frailty defined by an objective measurement, and reported ADRs/ADEs from/with heart failure medications.

resultsTwo reviewers screened 2419 articles; interrater reliability kappa = 0.88. Three observational studies (n = 2596), a secondary analysis of two RCTs (n = 2098) and two cohort studies (n = 498) were included in a narrative synthesis. Frail patients in randomised trials of sacubitril/valsartan, aliskiren, or enalapril had twice the risk of mortality (hazard ratio [HR] 2.09, 1.62-2.71) and hospitalisations (HR 1.82, 1.37-2.41) compared with robust patients, which may reflect responsiveness to medications and/or factors unrelated to medication use. Hospitalisations from falls, tiredness and nausea were probably attributable to digoxin and possibly preventable according to the Naranjo and Hallas scales, respectively.

conclusionThe potential harms from heart failure medications in frail older people are poorly studied and understood. Clinical trials and pharmacovigilance studies should include frailty as a covariate to inform medication optimisation for this vulnerable and growing population. REGISTRATION: Prospero registration number: CRD 42021253762.

Indexed as

Drug-Related Side Effects and Adverse ReactionsFrailtyHeart FailureAgedAminobutyratesBiphenyl CompoundsHumansPharmaceutical PreparationsPrevalenceAminobutyratesBiphenyl CompoundsPharmaceutical Preparationssacubitril

Identifiers

PMID35761118
PMCPMC9355931
OpenAlexW4283660367

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.