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 co-morbidity 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.
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 co-morbidity 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.
Authors: Dennis T Ko; David A Alter; Peter C Austin; John J You; Douglas S Lee; Feng Qiu; Therese A Stukel; Jack V Tu Journal: Am Heart J Date: 2008-02 Impact factor: 4.749
Authors: Donald Lloyd-Jones; Robert J Adams; Todd M Brown; Mercedes Carnethon; Shifan Dai; Giovanni De Simone; T Bruce Ferguson; Earl Ford; Karen Furie; Cathleen Gillespie; Alan Go; Kurt Greenlund; Nancy Haase; Susan Hailpern; P Michael Ho; Virginia Howard; Brett Kissela; Steven Kittner; Daniel Lackland; Lynda Lisabeth; Ariane Marelli; Mary M McDermott; James Meigs; Dariush Mozaffarian; Michael Mussolino; Graham Nichol; Véronique L Roger; Wayne Rosamond; Ralph Sacco; Paul Sorlie; Randall Stafford; Thomas Thom; Sylvia Wasserthiel-Smoller; Nathan D Wong; Judith Wylie-Rosett Journal: Circulation Date: 2010-02-23 Impact factor: 29.690
Authors: S Thavapalachandran; D P Leong; M K Stiles; B John; H Dimitri; D H Lau; P J Psaltis; A G Brooks; M Alasady; H S Lim; G D Young; P Sanders Journal: Intern Med J Date: 2009-10 Impact factor: 2.048