Evidence map›Paper›PMID 39698760›Full record

ArticleInternal medicine journal2025

Prevalence of heart failure pharmacotherapy utilisation, frailty and adverse drug events among hospitalised adults older than 75 years: a multicentre cross-sectional study.

Mai H Duong, Danijela Gnjidic, Andrew J McLachlan, Kevin Winardi, Alexandra A Bennett, Fiona Blyth, David Le Couteur, Sarah N Hilmer

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

Article in Internal medicine journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
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.

Mai H DuongLaboratory of Ageing and Pharmacology, Kolling Institute, Northern Sydney Local Health District, Sydney, New South Wales, Australia.ORCID 0000-0002-6764-3233
Danijela GnjidicFaculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0002-9404-3401
Andrew J McLachlanFaculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0003-4674-0242
Kevin WinardiLaboratory of Ageing and Pharmacology, Kolling Institute, Northern Sydney Local Health District, Sydney, New South Wales, Australia.ORCID 0009-0007-7787-8208
Alexandra A BennettFaculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0002-9900-5316
Fiona BlythFaculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0003-1128-6756
David Le CouteurFaculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0002-4227-5817
Sarah N HilmerLaboratory of Ageing and Pharmacology, Kolling Institute, Northern Sydney Local Health District, Sydney, New South Wales, Australia.ORCID 0000-0002-5970-1501

Funding

Faculty of Medicine and Health, University of Sydney, Postgraduate Research Support SchemeHeart Research Australia (HROz), 2023-2024 ScholarshipNational Health and Medical Research Council, Postgraduate Scholarship 2020 APP1191018
6 · The paper itself

Abstract

backgroundOptimal heart failure (HF) pharmacotherapy (guideline-directed medical therapy and diuretics) in older people with frailty is uncertain due to limited evidence.

aimsTo evaluate utilisation of HF pharmacotherapy and prevalence of polypharmacy, adverse drug events (ADEs), falls, delirium, renal impairment and duration of hospitalisation in older inpatients, according to frailty.

methodsA retrospective cross-sectional study of the TO HOME cohort of 2000 inpatients ≥75 years admitted for ≥48 h to rehabilitation, geriatric or general medicine from 1 July 2016 to 30 June 2017 across six hospitals in Sydney, Australia. Data were collected from electronic medical records. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification identified HF diagnosis, ADEs and frailty using hospital frailty risk score. Outcomes included utilisation of HF pharmacotherapy; polypharmacy; ADEs, falls, delirium, renal and impairment; and duration of hospitalisation.

resultsAmong 439 (22.0% of TO HOME cohort) patients with undifferentiated HF, 284 (69.5%) had intermediate or high risk of frailty, and 412 (94%) took ≥1 HF pharmacotherapy, with 357 (81.3%) patients on loop diuretics. Patients with high frailty risk frequently continued beta-blockers (70%) and discontinued renin-angiotensin system inhibitors (57%). Most patients experienced polypharmacy (n = 426, 97.0%). Renal impairment prevalence was 67%-76% across frailty groups. Increasing frailty risk (low, intermediate and high) was associated with increasing prevalence of ADEs (31%, 56% and 84%), falls (12%, 25% and 46%) and delirium (8%, 27% and 49%) and longer hospitalisation.

conclusionsFrailty, HF-pharmacotherapy changes in hospital and ADEs were common among older inpatients with HF. The association of adverse outcomes according to frailty needs further investigation. Poor documentation of HF phenotype may be a barrier to medication optimisation in older inpatients.

Indexed as

Drug-Related Side Effects and Adverse ReactionsFrailtyHeart FailureHospitalizationAgedAged, 80 and overAustraliaCross-Sectional StudiesDiureticsFemaleHumansMalePolypharmacyPrevalenceRetrospective StudiesDiureticscongestive heart failuredata visualisationdrug utilisationguideline adherenceobservational studypolypharmacy

Identifiers

PMID39698760
PMCPMC11817903

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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.