Predictors of Over-the-Counter Drug and Herbal Therapies Use in Elderly Patients With Heart Failure

Abstract 

Background

Over-the-counter (OTC) drug and herbal therapies (HT) may worsen heart failure or interact with prescription medications. Frequency of and predictors for routine OTC drug and HT use are not well studied.

Methods and Results

We examined routine use of OTC drug and HT in patients at 8 medical centers. Medical conditions independently associated with use of OTC drugs, HT, or both were assessed using multivariable logistic regression models. Of 374 subjects, OTC drug and HT were routinely used by 349 and 43 patients, respectively. Mean age was 69.6 ± 13.1 years, 63% were male, and 81% were Caucasian. Common OTC drugs were antiplatelets (baby-dose aspirin), vitamins, acetaminophen, antacids, laxatives, and calcium. The most common HT used was echinacea. History of hypercholesterolemia was associated with higher OTC drug use (OR 4.36; 95% CI 1.60–11.87; P = .004); renal failure predicted less use (OR 0.09; 95% CI 0.01–0.59; P = .013). History of hypertension was associated with less HT use (OR 0.47, 95% CI 0.24–0.92; P = .028).

Conclusions

In HF patients, routine use of OTC drugs was common, but HT use was not. OTC drugs were used more often in patients with hypercholesterolemia and were used for a variety of reasons; thus, routine assessment and individualized education are advocated.

Key words: Antiplatelet agents, aspirin, acetaminophen, echinacea