Analyses of drugs stored at home by elderly patients with chronic heart failure.
BACKGROUND
Evidence-based pharmacotherapy improves morbidity and mortality in patients with chronic heart failure (CHF). Medication adherence management is important for the effectiveness and safety of treatment. This study investigated drugs stored at home by elderly CHF patients.


RESULTS
One hundred and one patients with stable CHF age ≥65 years were visited at home where a standardized interview and a thorough assessment of medication were performed. Mean age of the patients was 77.7 ± 6.1 years, 53 % male, mean NYHA functional class of 2.8 ± 0.7 and a Minnesota-Living-with-Heart-Failure score of 59.4 ± 28.6 points indicating reduced quality of life. The mean number of different drug packs per patient was 13.1 ± 5.5, corresponding to a mean indexed value per patient of <euro>403 ± 48. Cardiovascular drugs accounted for 32 % of the packs. On average, 2.4 ± 3.2 packs contained medication that was not taken by the patient (18 % of the medication, mean indexed value <euro>61 ± 8). Fifty-six percent of the unused drugs were prescribed by general practitioners, 23 % in the hospital, and 7 % by medical specialists and 14 % were over-the-counter drugs. Sixty-three packages (5 %) of the drugs at home were expired (mean indexed value per patient <euro>12 ± 3).


CONCLUSIONS
On average, elderly patients with CHF have to manage 13 different drug packs per day at home of which a significant portion is not taken as prescribed. New strategies are needed to support medicines management at home.
Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Kirrberger Str., Geb. 40, 66421, Homburg/Saar, Germany, sebastian.ewen@uks.eu.
Sebastian
S
Ewen
Tanja
T
Baumgarten
Volker
V
Rettig-Ewen
Felix
F
Mahfoud
Nina
N
Griese-Mammen
Martin
M
Schulz
Michael
M
Böhm
Ulrich
U
Laufs
D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D005260:Female; D005858:Germany / Q000453:epidemiology; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D004366:Nonprescription Drugs / Q000627:therapeutic use*; D019338:Polypharmacy; D012651:Self Medication / Q000706:statistics & numerical data; D016903:Drug Monitoring
D002317:Cardiovascular Agents; D004366:Nonprescription Drugs