The use of potentially harmful drugs in heart failure hospitalizations
The evaluation of heart failure hospitalizations related care delivery have traditionally been focused on quality measures for the use of medications to decrease morbidity and mortality. Pharmaceutical intervention in heart failure has improved both morbidity and mortality in patients, but certain drug exposure used in the treatment of other conditions can worsen heart failure symptoms. Although established guidelines recommend against the use of potentially harmful drugs (PHD), it is unknown what the incidence of exposure is during hospitalizations for heart failure and the effect on hospitalization outcomes. This retrospective analysis on about 3.26 million heart failure related hospitalization records for patients receiving inpatient care during January 2011-December 2014 at 121 academic medical centers across the United States demonstrated an overall exposure to potentially harmful drugs of approximately 10%. More exposure to PHD was observed in the principal heart failure hospitalizations compared to secondary heart failure hospitalizations (12.4% vs. 9.8%). Exposure to any PHD was associated with an increase in hospitalization length of stay. Average length of stay was 10.1±3.9 days in the hospitalizations exposed to PHD vs 7.6±1.4 days without exposure. An increase in in-hospital mortality was associated with PHD exposure only (3.3% vs 3.7%) other subtypes of heart failure hospitalizations had no effect or decrease mortality with exposure to potentially harmful drugs. This data identified that exposure to PHD during heart failure hospitalizations is frequent. The increase use in resources associated with hospital length of stay and ICU resources associated with PHD exposure could possibly be averted with minimizing the use of PHD.
Putney, David R, "The use of potentially harmful drugs in heart failure hospitalizations" (2015). Texas Medical Center Dissertations (via ProQuest). AAI10036300.