The following is a summary of “Definition of polypharmacy in heart failure: A scoping review of the literature,” published in the April 2024 issue of Cardiology by Patel et al.

Patients with heart failure (HF) often take many medications, causing potential problems like drug interactions, cognitive impairment, and medication non-compliance. However, what exactly counts as “polypharmacy” in these cases is unclear.

Researchers conducted a retrospective study to determine the most common definition of polypharmacy in patients with HF.

They used databases like Medline, Embase, CINAHL, and Cochrane for articles on polypharmacy, HF, and deprescribing. Out of 7,949 related articles found, only 59 were eligible for the study, excluding those without a clear polypharmacy definition in patients with HF or including patients under 18.

Of the 59 articles, 49% (n=29) were retrospective, 20% (n=12) were prospective, 10% (n=6) were cross-sectional, and 27% (n=16) were review articles. While most articles did not specify the type of HF they focused on, 20% (n=12) focused on HF with reduced ejection fraction (HFrEF), and 10% (n=6) were on HF with preserved ejection fraction (HFpEF), along with 69% (n=41) focused on both diagnosis or unspecified diagnosis. Five medications were the most common polypharmacy cutoff (59%, n=35). However, some newer studies suggested using ten medications as a cutoff (14%, n=8).

Investigators concluded that defining polypharmacy in patients with HF varies widely, but a cutoff of ten medications might make more sense practically.

Source: ncbi.nlm.nih.gov/pmc/articles/PMC11027783