Polypharmacy rising among seniors with heart failure

The number of Quebecers aged 65 and over suffering from heart failure has doubled since the start of the century—and they're taking more and more different pharmacological treatments. So finds a study from the National Institute of Public Health of Quebec (INSPQ), released this month, on trends in polypharmacy among Quebec seniors suffering from heart failure between 2000 and 2019. In 2019, nearly 70.7% of people aged 65 and over suffering from heart failure used 10 or more different medications, compared to 62.2% in 2000. More precisely, the share of these patients having consumed 15 or more different medications and 20 or more was 42.2% and 21.2% in 2019, compared to 30.6% and 12.2% respectively in 2000. “These results show that the disease comes with a significant pharmacological burden,” said pharmacist Caroline Sirois, full professor at the faculty of pharmacy at Laval University, who collaborated on the study. Mixing multiple medications can increase the risk of adverse health effects— those adverse effects may then be confused with the manifestation of a new symptom of the disease, leading to yet a new drug prescribed, ultimately resulting in a drug cascade. READ: Deprescribing: Three main types of meds it may be worth helping your patients cut The INSPQ portrait also highlights a drop in the proportion of patients taking at least one angiotensin system medication (angiotensin-converting enzyme inhibitors/angiotensin receptor antagonists/angiotensin-neprilysin receptor inhibitors). “What disturbed us is that we did not find the reason behind the reduction in prescription of a class of drugs, such as ACEIs and ARBs, which is really recommended,” noted the researcher. The reasons for this trend should be explored, according to the INSPQ. Nevertheless, Caroline Sirois said other medications recommended according to the guidelines for the treatment of HF are increasingly used as a priority, while those that should be avoided seem to be decreasing in patients' consumption history. “We tend to treat in silos and the portrait allows us to position ourselves to look at all medications and beyond each disease, because it can do a lot,” said Sirois. She hopes this will provoke reflection among health professionals and a re-evaluation of the medication of certain patients.

Polypharmacy rising among seniors with heart failure

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