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Review
. 2025 Mar;20(2):599-609.
doi: 10.1007/s11739-024-03791-5. Epub 2024 Oct 15.

Deprescribing strategies in older patients with heart failure

Gregorio Tersalvi  1   2 , Vittorio Beltrani  3   4 , Marco Peronti  5 , Ludovico Furlan  6   7 , Andrew Foy  8   9 , Luigi Biasco  10   11
Affiliations
Review

Deprescribing strategies in older patients with heart failure

Gregorio Tersalvi et al. Intern Emerg Med. 2025 Mar.

Abstract

Older patients with heart failure are particularly vulnerable due to a wide range of associated comorbidities, disability, and frailty. This population often receives multiple prescriptions, increasing the risk of adverse drug reactions, non-adherence, and drug interactions. Deprescribing, which involves reducing the number of medications to the lowest clinically reasonable limit, has the potential to decrease the risk of drug interactions and enhance patients' quality of life. Moreover, simplifying medication regimens may improve adherence to essential heart failure therapies. This scientific review aims to comprehensively examine deprescribing strategies in older patients with heart failure. It explores the rationale, challenges, benefits, and potential approaches to optimizing medication regimens in this vulnerable population. Furthermore, the review suggests a practical, step-by-step approach for performing deprescribing in older patients with heart failure.

Keywords: Competing risk; Drug interactions; Frailty; Medication simplification; Polypharmacy.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare they have no conflict of interest. Human and animal rights statement: This article does not contain any studies directly involving human participants as it is a review of previously published data. Informed consent: Formal consent is not required for this type of study.

References

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