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Review
. 2024 Mar 1;9(1):51-65.
doi: 10.22540/JFSF-09-051. eCollection 2024 Mar.

What is the association of polypharmacy with frailty in heart failure? A systematic review and meta-analysis

Konstantinos Prokopidis  1 , Giuseppe Dario Testa  2 , Nicola Veronese  3 , Yannis Dionyssiotis  4 , Joseph McLean  5 , Lauren E Walker  6   7 , Rajiv Sankaranarayanan  7   8   9
Affiliations
Review

What is the association of polypharmacy with frailty in heart failure? A systematic review and meta-analysis

Konstantinos Prokopidis et al. J Frailty Sarcopenia Falls. .

Abstract

This systematic review and meta-analysis aimed to explore the differences in the number of prescribed medications and polypharmacy risk between patients with heart failure (HF) and frailty vs. those with HF but without frailty. Eligible studies included observational or experimental studies in patients aged ≥50 years. Thirteen studies met the criteria and were included in the final analysis. Patients with frailty and HF exhibited a higher risk of polypharmacy (OR: 1.87, 95% CI 1.72 - 2.04, I2 = 0%, P < 0.01) compared to those without frailty. Results remained significant after adjusting for comorbidity status. Additionally, patients with frailty and HF were prescribed more medications compared to those without (k = 6; MD: 1.43, 95% CI 0.31 - 2.55, I2 = 94%, P = 0.01), with a high degree of heterogeneity. However, results were non-significant after adjustment for comorbidity status. Patients with HF and frailty have a higher need of polypharmacy compared to those without frailty, which may increase the risk of potentially inappropriate medications (PIM). Investigating the real-world prevalence of PIM may support clinicians in their routine assessment as part of a comprehensive management strategy in patients with HF and frailty.

Keywords: Frailty; Heart failure; Medications; PIM; Polypharmacy.

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Figures

Figure 1
Figure 1
Flowchart of the employed literature search.
Figure 2
Figure 2
Polypharmacy risk of patients with heart failure and frailty vs. patients without frailty.
Figure 3
Figure 3
Differences in number of medications between patients with heart failure and frailty vs. patients without frailty.
Supplementary Figure 1
Supplementary Figure 1
Risk of polypharmacy in patients with heart failure and frailty vs. without frailty aged below 70 years and in patients aged above 70.
Supplementary Figure 2
Supplementary Figure 2
Risk of polypharmacy in patients with heart failure and frailty vs. without frailty based on Fried’s criteria.
Supplementary Figure 3
Supplementary Figure 3
Risk of polypharmacy in patients with heart failure and frailty vs. without frailty based on similar reported health status.
Supplementary Figure 4
Supplementary Figure 4
Risk of polypharmacy in patients with heart failure and frailty vs. without frailty based on similar reported health status and Fried’s criteria.
Supplementary Figure 5
Supplementary Figure 5
Risk of polypharmacy in patients with heart failure and frailty vs. without frailty based on sufficient data regarding polypharmacy.
Supplementary Figure 6
Supplementary Figure 6
Risk of polypharmacy in patients with heart failure and frailty vs. without frailty based on studies with lower risk of bias.
Supplementary Figure 7
Supplementary Figure 7
Number of medications in patients with heart failure and frailty vs. without frailty based on Fried’s criteria.
Supplementary Figure 8
Supplementary Figure 8
Number of medications in patients with heart failure and frailty vs. without frailty based on similar reported health status.
Supplementary Figure 9
Supplementary Figure 9
Number of medications in patients with heart failure and frailty vs. without frailty based on studies with lower risk of bias.
See this image and copyright information in PMC

References

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