Polypharmacy Increases Heart Failure (HF) Readmission Rate

BackgroundHeart failure (HF) prevalence is increasing with an aging population and associated increasing comorbidities, and an expected concomitant increase in prescribed non-cardiac medications. The need to comply with clinical practice guidelines for multiple disease states often leads to polypharmacy; which in turn increases risk of drug-drug interactions, adverse drug reactions and nonadherence.HypothesisWe hypothesize that polypharmacy due to non-HF related medications at discharge (following a HF exacerbation) increases the risk of all cause re-admission.MethodsThis was an a retrospective cohort study of patients discharged from two hospitals in the Allegheny Health System, PA with a primary diagnosis of HF from 01/2017-12/2018 with at least 90 days follow-up. The data series were tested for difference in hospital readmission rates for HF at 30 and 90 days against the number of non-HF medications grouped into 8 incremental categories. The chi-square test was used to determine the significance of the observed readmission rates compared to random chance, with p<0.05 indicating significance.ResultsA total of 1367 patients were included in study analysis. There was a statistically significant association between increasing number of non-HF medications and 90 day readmission (p = 0.02).ConclusionsPolypharmacy of non-HF medications results in a consistently linear increases in HF readmission rate, incrementally dependent on the number of prescribed non-HF medications and is significantly associated with 90-day all-cause readmission.