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Observational Study
. 2019 Apr 1;19(1):76.
doi: 10.1186/s12872-019-1058-7.

Prevalence and determinants of Hyperpolypharmacy in adults with heart failure: an observational study from the National Health and Nutrition Examination Survey (NHANES)

Peter J Kennel  1 , Jerard Kneifati-Hayek  2 , Joanna Bryan  2 , Samprit Banerjee  3 , Irina Sobol  4 , Mark S Lachs  5 , Monika M Safford  2 , Parag Goyal  6   7
Affiliations
Observational Study

Prevalence and determinants of Hyperpolypharmacy in adults with heart failure: an observational study from the National Health and Nutrition Examination Survey (NHANES)

Peter J Kennel et al. BMC Cardiovasc Disord. .

Abstract

Background: While an expanding armamentarium of pharmacologic therapies has contributed to improved outcomes among adults with heart failure (HF) over the past two decades, this has also been accompanied by an increase in the number of medications taken by adults with HF. The use of at least 10 medications, defined as hyperpolypharmacy, is particularly notable given its association with adverse outcomes. We aimed to assess the prevalence and identify determinants of hyperpolypharmacy among adults with HF.

Methods: We studied adults aged ≥50 years with self-reported HF from the National Health And Nutrition Examination Survey (NHANES) in 2003-2014. We calculated weighted means and percentages to describe patient characteristics. We conducted a multivariable Poisson regression analysis to identify factors independently associated with hyperpolypharmacy; we adjusted for survey sampling, socio-demographics, comorbidity, geriatric conditions, and health care utilization. We examined 947 participants, representing 4.6 million adults with HF.

Results: The prevalence of hyperpolypharmacy was 26%. In a multivariable regression analysis, comorbidity count, ≥10 ambulatory contacts, and ≥ 3 hospitalizations were independently associated with hyperpolypharmacy. Interestingly, functional impairment and cognitive impairment were not independently associated with hyperpolypharmacy; while low annual household income and low educational status were each associated with an almost 2-fold increase in hyperpolypharmacy.

Conclusion: Hyperpolypharmacy is a common condition among adults with HF. We additionally found that low household income and low educational status are independently associated with hyperpolypharmacy, suggesting that non-medical factors may be contributing to this potentially harmful condition.

Keywords: Healthcare disparity; Heart failure; Polypharmacy.

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Conflict of interest statement

Ethics approval and consent to participate

This study was reviewed and approved by the National Center for Health Statistics research ethics review board, and written informed consent was obtained from all NHANES participants.

Consent for publication

Not applicable.

Competing interests

MMS has received research support from Amgen, unrelated to the topic of this manuscript.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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