Deprescribing heart medications may backfire
The benefit from describing medicines in the elderly has been put in doubt with a South Australian study showing that withdrawal of cardiovascular medications is associated with worse mortality.
The prospective study followed 239 medical inpatients ≥75 years on five or more medications prior to admission who were discharged to permanent residential aged care.
It found patients who had medications deprescribed had a nonsignificantly greater odds of dying within 90 days (OR 3.23; p = 0.136).
However deprescribing antihypertensives (OR 2.27, p = 0.05), statins (OR 4.95; p = 0.005) and diuretics (OR 0.33; p= 0.05) was significantly associated with increased mortality at 90 days. Readmissions and 1-year mortality rates were similar and there was no deterioration in quality of life when medications were deprescribed.
The study found patients with the least medication changes had the lowest mortality. The authors said deprescribing medications for inpatients in the last phase of life remained an important, but moving target.
“Nonspecific deprescribing might be no more beneficial than nonspecific prescribing,” they concluded.
Read more in Therapeutic Advances in Drug Safety
AV block alert for octreotide
A TGA Medicines Safety Update has flagged reports from Europe of atrioventricular blocks in patients receiving high doses of continuous intravenous infusion of octreotide and in patients receiving bolus octreotide intravenously.
The severity of atrioventricular block varies, with complete heart block resulting in cardiac arrest. Patients receiving high doses may need cardiac monitoring and treatment may include pacemaker insertion.