Antidepressant Prescribing Patterns in Heart Failure Patients at Residential Aged Care Facilities in Australia: A Cross-sectional Study

OBJECTIVE: Depression is associated with poor outcomes following heart failure. Information regarding the use and effectiveness of antidepressants in heart failure patients is lacking. This study aims to evaluate the prescribing patterns of antidepressants in patients with heart failure residing in aged care facilities. METHODS: This study was a cross-sectional analysis of de-identified Australian Residential Medication Management Reviews conducted between January 2016 and April 2017. SPSS version 24 software was used to analyze the data. Descriptive statistics were used to summarize age, gender, and antidepressants use. Wilcoxon signed-rank test was used to assess the differences in antidepressant prescribing between patients with and without heart failure. FINDINGS: Of 4369 patients, 980 (22.4%) had heart failure. Of those with heart failure, 410 (41.8%) were using at least one antidepressant. Mirtazapine was the most commonly prescribed antidepressant in patients with heart failure (27.8%) and without heart failure (27.3%). When grouping antidepressants for class, selective serotonin reuptake inhibitors were the most commonly prescribed in both groups. There was no statistically significant difference in antidepressant prescribing patterns between patients with and without heart failure (P = 0.961). CONCLUSION: Mirtazapine was the most commonly used antidepressant in heart failure patients residing in aged care facilities. This study has highlighted a need for a randomized controlled trial to evaluate the efficacy and safety of mirtazapine in the management of depression in patients with heart failure.