Use of heart failure medications in older individuals and associations with cognitive impairment
Background: To achieve the best treatment of heart failure, it is important to use all recommended drugs at their target doses. Given that underuse of medications can occur in individuals with cognitive impairment, we investigated the filled prescriptions and target doses of heart failure medication...
Published in: | BMC Geriatrics |
---|---|
Main Authors: | , , , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
Umeå universitet, Institutionen för integrativ medicinsk biologi (IMB)
2023
|
Subjects: | |
Online Access: | http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-214029 https://doi.org/10.1186/s12877-023-04223-3 |
id |
ftumeauniv:oai:DiVA.org:umu-214029 |
---|---|
record_format |
openpolar |
spelling |
ftumeauniv:oai:DiVA.org:umu-214029 2023-10-09T21:54:36+02:00 Use of heart failure medications in older individuals and associations with cognitive impairment Abramsson, Linnea Backman, Annica C. Lövheim, Hugo Edvardsson, David Gustafsson, Maria 2023 application/pdf http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-214029 https://doi.org/10.1186/s12877-023-04223-3 eng eng Umeå universitet, Institutionen för integrativ medicinsk biologi (IMB) Umeå universitet, Institutionen för omvårdnad Umeå universitet, Geriatrik Umeå universitet, Wallenberg centrum för molekylär medicin vid Umeå universitet (WCMM) School of Nursing and Midwifery, La Trobe University, VIC, Bundoora, Australia BMC Geriatrics, 1471-2318, 2023, 23:1, orcid:0000-0002-3408-2900 orcid:0000-0002-5271-4780 orcid:0000-0003-3615-4880 http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-214029 doi:10.1186/s12877-023-04223-3 PMID 37644427 Scopus 2-s2.0-85168925179 info:eu-repo/semantics/openAccess Cognitive impairment Filled prescriptions Heart failure Target doses Cardiac and Cardiovascular Systems Kardiologi Article in journal info:eu-repo/semantics/article text 2023 ftumeauniv https://doi.org/10.1186/s12877-023-04223-3 2023-09-22T14:01:43Z Background: To achieve the best treatment of heart failure, it is important to use all recommended drugs at their target doses. Given that underuse of medications can occur in individuals with cognitive impairment, we investigated the filled prescriptions and target doses of heart failure medication for older individuals with and without cognitive impairment as well as associated factors. Methods: The study was based on two separate datasets. The first dataset, which was based on data from questionnaires sent to nursing homes in Sweden, included 405 individuals with heart failure. The data were linked with the Swedish Prescribed Drug Register and the National Patient Register to obtain information regarding filled prescriptions of heart failure medications and heart failure diagnoses among the population. In the second dataset, medical records of individuals aged 75 years or older admitted to a hospital in northern Sweden were reviewed and individuals with heart failure were identified. Target doses of heart failure medications were evaluated in 66 individuals who lived at home. Results: Filled prescriptions of mineralocorticoid receptor antagonists and loop diuretics were significantly more common in individuals without cognitive impairment (OR 1.087; 95% CI 1.026–1.152, p < 0.05) and (OR 1.057; 95% CI 1.017–1.098, p < 0.05), respectively. There were no significant differences between individuals with and without cognitive impairment in terms of achieving target doses for any of the drug classes. A higher age was associated with fewer filled prescriptions and less ability to reach the target doses of beta blockers (OR 0.950; 95% CI 0.918–0.984, p < 0.05) and (OR 0.781; 95% CI 0.645–0.946, p < 0.05), respectively. Conclusions: Our results suggest that individuals with cognitive impairment are partly undertreated for heart failure in that they had fewer filled prescriptions of important heart medications. Separately, the relatively low proportion of older individuals reaching target doses is an ... Article in Journal/Newspaper Northern Sweden Umeå University: Publications (DiVA) BMC Geriatrics 23 1 |
institution |
Open Polar |
collection |
Umeå University: Publications (DiVA) |
op_collection_id |
ftumeauniv |
language |
English |
topic |
Cognitive impairment Filled prescriptions Heart failure Target doses Cardiac and Cardiovascular Systems Kardiologi |
spellingShingle |
Cognitive impairment Filled prescriptions Heart failure Target doses Cardiac and Cardiovascular Systems Kardiologi Abramsson, Linnea Backman, Annica C. Lövheim, Hugo Edvardsson, David Gustafsson, Maria Use of heart failure medications in older individuals and associations with cognitive impairment |
topic_facet |
Cognitive impairment Filled prescriptions Heart failure Target doses Cardiac and Cardiovascular Systems Kardiologi |
description |
Background: To achieve the best treatment of heart failure, it is important to use all recommended drugs at their target doses. Given that underuse of medications can occur in individuals with cognitive impairment, we investigated the filled prescriptions and target doses of heart failure medication for older individuals with and without cognitive impairment as well as associated factors. Methods: The study was based on two separate datasets. The first dataset, which was based on data from questionnaires sent to nursing homes in Sweden, included 405 individuals with heart failure. The data were linked with the Swedish Prescribed Drug Register and the National Patient Register to obtain information regarding filled prescriptions of heart failure medications and heart failure diagnoses among the population. In the second dataset, medical records of individuals aged 75 years or older admitted to a hospital in northern Sweden were reviewed and individuals with heart failure were identified. Target doses of heart failure medications were evaluated in 66 individuals who lived at home. Results: Filled prescriptions of mineralocorticoid receptor antagonists and loop diuretics were significantly more common in individuals without cognitive impairment (OR 1.087; 95% CI 1.026–1.152, p < 0.05) and (OR 1.057; 95% CI 1.017–1.098, p < 0.05), respectively. There were no significant differences between individuals with and without cognitive impairment in terms of achieving target doses for any of the drug classes. A higher age was associated with fewer filled prescriptions and less ability to reach the target doses of beta blockers (OR 0.950; 95% CI 0.918–0.984, p < 0.05) and (OR 0.781; 95% CI 0.645–0.946, p < 0.05), respectively. Conclusions: Our results suggest that individuals with cognitive impairment are partly undertreated for heart failure in that they had fewer filled prescriptions of important heart medications. Separately, the relatively low proportion of older individuals reaching target doses is an ... |
format |
Article in Journal/Newspaper |
author |
Abramsson, Linnea Backman, Annica C. Lövheim, Hugo Edvardsson, David Gustafsson, Maria |
author_facet |
Abramsson, Linnea Backman, Annica C. Lövheim, Hugo Edvardsson, David Gustafsson, Maria |
author_sort |
Abramsson, Linnea |
title |
Use of heart failure medications in older individuals and associations with cognitive impairment |
title_short |
Use of heart failure medications in older individuals and associations with cognitive impairment |
title_full |
Use of heart failure medications in older individuals and associations with cognitive impairment |
title_fullStr |
Use of heart failure medications in older individuals and associations with cognitive impairment |
title_full_unstemmed |
Use of heart failure medications in older individuals and associations with cognitive impairment |
title_sort |
use of heart failure medications in older individuals and associations with cognitive impairment |
publisher |
Umeå universitet, Institutionen för integrativ medicinsk biologi (IMB) |
publishDate |
2023 |
url |
http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-214029 https://doi.org/10.1186/s12877-023-04223-3 |
genre |
Northern Sweden |
genre_facet |
Northern Sweden |
op_relation |
BMC Geriatrics, 1471-2318, 2023, 23:1, orcid:0000-0002-3408-2900 orcid:0000-0002-5271-4780 orcid:0000-0003-3615-4880 http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-214029 doi:10.1186/s12877-023-04223-3 PMID 37644427 Scopus 2-s2.0-85168925179 |
op_rights |
info:eu-repo/semantics/openAccess |
op_doi |
https://doi.org/10.1186/s12877-023-04223-3 |
container_title |
BMC Geriatrics |
container_volume |
23 |
container_issue |
1 |
_version_ |
1779318253019987968 |