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BMC Primary Care
Published in: BMC Primary Care 1/2014

Open Access 01-12-2014 | Research article

Cardiovascular polypharmacy is not associated with unplanned hospitalisation: evidence from a retrospective cohort study

Authors: Sarah C Appleton, Gary A Abel, Rupert A Payne

Published in: BMC Primary Care | Issue 1/2014

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Abstract

Background

Polypharmacy is often considered suggestive of suboptimal prescribing, and is associated with adverse outcomes. It is particularly common in the context of cardiovascular disease, but it is unclear whether prescribing of multiple cardiovascular medicines, which may be entirely appropriate and consistent with clinical guidance, is associated with adverse outcome. The aim of this study was to assess the relationship between number of prescribed cardiovascular medicines and unplanned non-cardiovascular hospital admissions.

Methods

A retrospective cohort analysis of 180,815 adult patients was conducted using Scottish primary care data linked to hospital discharge data. Patients were followed up for one year for the outcome of unplanned non-cardiovascular hospital admission. The association between number of prescribed cardiovascular medicines and hospitalisation was modelled using logistic regression, adjusting for key confounding factors including cardiovascular and non-cardiovascular morbidity and non-cardiovascular prescribing.

Results

25.4% patients were prescribed ≥1 cardiovascular medicine, and 5.7% were prescribed ≥5. At least one unplanned non-cardiovascular admission was experienced by 4.2% of patients. Admissions were more common in patients receiving multiple cardiovascular medicines (6.4% of patients prescribed 5 or 6 cardiovascular medicines) compared with those prescribed none (3.5%). However, after adjusting for key confounders, cardiovascular prescribing was associated with fewer non-cardiovascular admissions (OR 0.66 for 5 or 6 vs. no cardiovascular medicines, 95% CI 0.57-0.75).

Conclusions

We found no evidence that increasing numbers of cardiovascular medicines were associated with an increased risk of unplanned non-cardiovascular hospitalisation, following adjustment for confounding. Assumptions that polypharmacy is hazardous and represents poor care should be moderated in the context of cardiovascular disease.
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Metadata
Title
Cardiovascular polypharmacy is not associated with unplanned hospitalisation: evidence from a retrospective cohort study
Authors
Sarah C Appleton
Gary A Abel
Rupert A Payne
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2014
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/1471-2296-15-58

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