Prevalence and Determinants of Hyperpolypharmacy in Adults with Heart Failure

Introduction Hyperpolypharmacy (HPP), defined as the use of ≥10 medications, is a well-described phenomenon in Geriatrics, that is linked to increased risk for hospitalization, disability, and mortality. Given the number of cardiovascular medications necessary to adhere to clinical practice guidelines, coupled with a high prevalence of non-cardiac comorbidity, adults with CHF may be at elevated risk for HPP. Objective We aimed to assess the prevalence and identify determinants of HPP among adults with CHF. Methods Using 2003-2014 data from NHANES (a cross-sectional survey representative of the non-institutionalized population in the United States), we examined adults aged ≥50 years with self-reported CHF. We defined HPP as the condition of taking ≥10 medications. We used weighted means and percentages to determine population-based characteristics. To identify factors independently associated with HPP, we performed a multivariable Poisson regression analysis, adjusting for sociodemographics, comorbidity, geriatric conditions, and health care utilization. Results We studied 947 participants with CHF, which represented 4.6 million adults with CHF in the USA. The mean age of the population was 70 years, 49% were women, and 77% were white. Most participants had an education level of high school or below (87%), and a substantial proportion (27%) reported an annual household income of Conclusion Hyperpolypharmacy is common in adults with CHF. While its prevalence does not vary according to impairments in function or cognition, low household income and low educational status are independently associated with HPP. This suggests that non-medical factors may be contributing to this potentially harmful practice, and warrants further investigation.