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\begin{document}

\title{Characterising disease and prescribing patterns in people with heart
failure and multiple chronic conditions: a single-centre descriptive
cohort study}



\author[1]{schabnam saied}%
\author[1]{Jameela  Bahar}%
\author[1]{Knievel  Mashida}%
\author[1]{Olivia Heron}%
\author[2]{Konstantinos Prokopidis}%
\author[2]{sarah gulliford}%
\author[2]{Kelly Connah}%
\author[2]{Debar Rasoul}%
\author[2]{Asan Akpan}%
\author[2]{Chukwemeka  Oguguo }%
\author[2]{Lauren Walker}%
\author[2]{rajiv sankaranarayanan}%
\affil[1]{University of Liverpool}%
\affil[2]{Aintree University Hospitals NHS Foundation Trust}%


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  \date{May 26, 2024}


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\begin{abstract}
Introduction: Heart failure (HF) is a complex condition often
accompanied by comorbidities such as renal dysfunction, diabetes
mellitus (DM), chronic respiratory diseases, frailty, and anaemia,
necessitating intricate management involving multiple therapeutics.
Objectives: This retrospective cohort study aims to characterize
prescribing patterns and identify potentially inappropriate polypharmacy
in individuals with HF and multimorbidity. Methods: Data was collected
from 234 HF adults with multimorbidity under the care of the HF
multidisciplinary team at Liverpool University Hospital Foundation Trust
(LUHFT) from January 2020 -February 2021. Results: The mean age was
71.5\selectlanguage{ngerman}±13.9 and 44\% were female. ACCI was 6.9±3.3, CFS was 5.5±3.2,
polypharmacy burden was high at 10.2±3.9, and ACB was 1.45±0.9. ACB was
higher in those with CFS\selectlanguage{english}[?]6 vs. those with CFS\textless{}6 (1.5+-1.1 vs.
1.1+-0.9; p=0.02). The proportion of adults with HF on treatment for
depression was 19.7\%, chronic pain 35\%, and chronic constipation
19.7\%. Fifteen percent received oral iron instead of the appropriate
intravenous iron replacement, while 17.9\% of the cohort were observed
to be nearing the end of their lives. Regarding PIM use, 9\% were on
either DAPT/anticoagulant plus anti-platelet therapy beyond 12 months of
an acute coronary event. One in five patients received PPIs without
clear justification. Conclusion: Adults with frailty and HF have a
higher ACB. This study identifies targets for de-prescribing
interventions in HF, including inappropriate PPI and DAPT/anticoagulant
plus anti-platelet therapy, which are seeing in 1:5 and 1:10 adults with
HF in the clinic, respectively. Tailored guidelines can aid shared
decision-making, reducing drug-related complications in this group.%
\end{abstract}\selectlanguage{ngerman}%



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\textbf{Hosted file}

\verb`Latest submission - BCJP_submission_paper_-_no_pdf_ (3).docx`  available at \url{https://authorea.com/users/765076/articles/764726-characterising-disease-and-prescribing-patterns-in-people-with-heart-failure-and-multiple-chronic-conditions-a-single-centre-descriptive-cohort-study}

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