2018•European Heart JournalRequires access
6013Drug therapy in adult congenital heart disease: the burden of polypharmacy
Odilia I. Woudstra, Joey M. Kuijpers, Folkert J. Meijboom, Martijn C. Post, Monique R.M. Jongbloed, Arie P.J. van Dijk, Joost P. van Melle, Thelma C. Konings, Aeilko H. Zwinderman, Barbara J.M. Mulder, Berto J. Bouma
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Abstract
Background: Adult congenital heart disease (ACHD) increasingly includes frail individuals with more severe congenital heart defects (CHD), with sequelae and comorbidities requiring pharmacotherapy. Half of ACHD patients use chronic medication, which may cumulate over time. Purpose: This study aims to investigate the prevalence, risk factors, and contributing drugs to polypharmacy, and its association with mortality in ACHD, compared to age- and sex-matched referents from the general population. Methods: We identified patients from our nationwide ACHD registry and age- and sex-matched referents from the general population in a 1:10-ratio in the national Dispensed Drug Register and Cause of Death Register for the years 2006–2014. Drugs were classified according to the Anatomical Therapeutic Chemical classification, aggregated per year. Generalized estimating equations were used to determine associations between characteristics and polypharmacy, defined as ≥5 different dispensed drug types per year. Associations between baseline polypharmacy and mortality were analyzed in subjects surviving their baseline year using multivariable Cox regression.