Co-morbidity and potential treatment conflicts in elderly heart failure patients: A retrospective, cross-sectional study of administrative claims data
Date
2011
Authors
Caughey, G.
Roughead, E.
Shakib, S.
Vitry, A.
Gilbert, A.
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Drugs and Aging, 2011; 28(7):575-581
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Abstract
Co-morbidity of both cardiac and non-cardiac conditions is common in the elderly with heart failure (HF) and can be associated with adverse clinical outcomes.The aims of this study were to examine the prevalence of co-morbidity and potential treatment conflicts that may result in adverse clinical outcomes in a large cohort of elderly HF patients.We conducted a cross-sectional study using administrative claims data (1 April to 31 July 2007) from the Department of Veterans' Affairs, Australia, on all veterans aged ≥65 years with HF. Co-morbidities were defined using the pharmaceutical based co-morbidity index Rx-Risk-V. Potential treatment conflicts for patients with HF and co-morbid diseases were identified from Australian clinical guidelines or reference compendia and their prevalence in the data were determined.A total of 6730 patients were included in the study, with a median of 6 co-morbid conditions (interquartile range [IQR] 4-7) and 11 (IQR 8-15) unique medicines. Almost the entire HF cohort (97.8%) were identified as having at least one co-morbid condition that may cause a potential treatment conflict, with 55% having three or more. The conditions identified as being of greatest concern, based on their prevalence and potential for treatment conflict, were chronic airways disease, depression, chronic pain/inflammatory disease, glaucoma, diabetes mellitus and diseases treatable with corticosteroids.Potential treatment conflicts are common in the highly co-morbid population of elderly patients with HF, and may influence the therapeutic management of not only HF but all conditions present.
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Copyright 2011 Adis International