Use of potentially inappropriate medications for heart failure according to the three sets of heart failure-specific criteria in Thai older patients with heart failure

OBJECTIVE: To study the prevalence of potentially inappropriate medications for patients with heart failure (PIMHF) use and to identify factors associated with PIMHF use in Thai older HF patients. METHODS: This cross-sectional analytical survey included data on older (≥ 60 years) HF patients obtained from the electronic medical record databases of secondary- and tertiary-care hospitals. The medication profiles of patients were assessed to examine whether they were prescribed any PIMHF after an HF diagnosis. For PIMHF detection, the HF-specific criteria, including 2014 St Vincent criteria, 2019 Beers criteria, and 2021 Thailand criteria were applied. The prevalence of PIMHF use was expressed as percentages. The associated factors were identified using a binary logistic regression analysis, expressed as the adjusted odds ratio (aOR) and 95% confidence interval (95% CI). RESULTS: A total of 2,639 patients were included in the study. Thirty-two PIMHF were found to have been prescribed to these patients. The prevalence of PIMHF use identified by the ST Vincent criteria, the Beers criteria, the Thailand criteria, and the three combined criteria was 23.76%, 19.67%, 21.18%, and 25.16%, respectively. The factors associated with PIMHF use were secondary-care hospital (aOR = 1.54, 95% CI: 1.26−1.87), HF with preserved ejection fraction (HFpEF) (aOR = 1.81, 95% CI: 1.38−2.38), hypertension (HTN) (aOR = 1.24, 95% CI: 1.02−1.51), diabetes mellitus (DM) (aOR = 1.39, 95% CI: 1.10−1.75), chronic pulmonary diseases (CPD) (aOR = 2.09, 95% CI: 1.56−2.80), and connective tissue diseases (CTD) (aOR = 5.10, 95% CI: 2.20−11.83). CONCLUSIONS: PIMHF are commonly used in Thai older HF patients. The factors associated with PIMHF use identified in this study include secondary-care hospital, HFpEF, HTN, DM, CPD, and CTD.