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Erschienen in:
01.07.2011 | Original Research Article
Co-Morbidity and Potential Treatment Conflicts in Elderly Heart Failure Patients
A Retrospective, Cross-Sectional Study of Administrative Claims Data
Erschienen in: Drugs & Aging | Ausgabe 7/2011
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Background: 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.
Objectives: The aims of this study were to examine the prevalence of comorbidity and potential treatment conflicts that may result in adverse clinical outcomes in a large cohort of elderly HF patients.
Methods: 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.
Results: 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.
Conclusions: 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.