Drug treatment of heart failure--do nursing-home residents deserve better?
OBJECTIVE
To describe and assess drug treatment of heart failure (HF) in nursing-home residents.


METHODS
Descriptive cross-sectional study. Individual patient information was obtained from the medical records and drug-dispensing cards.


METHODS
Nursing homes in Bergen, Norway.


METHODS
Demographic data, diagnostic data (main diagnoses, diagnostic indications for the drugs used), medications (drugs, dosage and duration of use).


RESULTS
Data were gathered from 23 of 27 obtainable institutions representing 1552 residents (86% of the Bergen nursing-home population); 469 (30%) of the residents used drugs for HF, the majority of whom (293 patients) were treated with furosemide only. Supplementary angiotensin-converting enzyme (ACE) inhibitors (predominantly in sub-target doses) were provided to 17% of the HF patients. About one out of four used drug combinations which we considered to be potentially harmful for HF patients.


CONCLUSIONS
ACE inhibitors are probably under-utilised for HF in nursing-home residents. Potentially harmful drug combinations commonly occur. Both diagnosis and drug treatment for HF should be challenged in the nursing-home setting.
Ruths
S
S
Department of Public Health and Primary Health Care, University of Bergen, Norway. sabine.ruths@isf.uib.no
Straand
J
J
Nygaard
H A
HA
Hodneland
F
F
D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy*; D006707:Homes for the Aged / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D009735:Nursing Homes / Q000592:standards*; D011787:Quality of Health Care
D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics