Trends and concerns of potentially inappropriate medication use in patients with cardiovascular diseases

ABSTRACT

Introduction: The use of potentially inappropriate medications (PIM) is an alarming social risk factor in cardiovascular patients. PIM administration may result in iatrogenic disorders and adverse consequences may be attenuated by limiting PIM intake.

Areas covered: The goal of this review article is to discuss the trends, risks, and concerns regarding PIM administration with focus on cardiovascular patients. To find data, we searched literature using electronic databases (Pubmed/Medline 1966–2021 and Web of Science 1975–2021). The data search terms were cardiovascular diseases, potentially inappropriate medication, potentially harmful drug–drug combination, potentially harmful drug–disease combination, drug interaction, deprescribing, and electronic health record.

Expert opinion: Drugs for heart diseases are the most commonly prescribed medications in older individuals. Despite the availability of explicit and implicit PIM criteria, the incidence of PIM use in cardiovascular patients remains high ranging from 7 to 85% in different patient categories. Physician-induced disorders often occur when PIM is administered and adverse effects may be reduced by limiting PIM intake. Main strategies promising for addressing PIM use include deprescribing, implementation of systematic electronic records, pharmacist medication review, and collaboration among cardiologists, internists, geriatricians, clinical pharmacologists, pharmacists, and other healthcare professionals as basis of multidisciplinary assessment teams.

KEYWORDS:

• Cardiovascular diseases
• COVID-19
• polypharmacy
• potential drug–drug interaction
• potentially inappropriate medication
• risk factor

Article highlights

• Potentially inappropriate medication (PIM) prescription is an alarming social risk factor.

• The manuscript discusses the trends, risks, and concerns regarding PIM use with focus on cardiovascular patients.

• More personalized tools for the control of drug therapy in elderly cardiovascular patients are essential in clinical practice.

This box summarizes key points contained in the article.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work was supported, in part, by the State Project ‘Science’ (No. AAAA-A15-115123110026-3).