Potentially inappropriate medications for patients with heart failure: a nationwide retrospective study from 2012 to 2022

Background As the population ages, addressing potentially inappropriate medications (PIMs) for patients with heart failure (HF) is extremely important, and many medical professionals are working on this issue. However, it is unclear whether the various PIM countermeasures being implemented throughout Japan are leading to the suppression of PIMs for patients with HF. The characteristics of hospitalised patients with HF and prescription patterns of PIMs over the past decade were investigated.Method Data from the Japanese Cardiovascular Disease Registry Database and the Diagnostic Procedure Combination Database of 1,452,034 inpatients aged ≥18 years diagnosed with HF between April 2012 and March 2022 were analysed. The study was stratified into three periods: 2012–2015, 2016–2019, and 2020–2022.Results Typical PIMs, such as benzodiazepine, anxiolytics medications, α-glucosidase inhibitors, thiazolidine, sulfonylurea, non-dihydropyridine calcium antagonists, digoxin, non-steroidal anti-inflammatory drugs, anticholinergics, and β2 agonists showed decreased prescription trends over the years (P for all trends <0.01). Inpatient PIM prescriptions rarely continued at discharge.Conclusion These results suggest that typical PIMs for hospitalised patients with HF have declined during the past decade. Medical providers should contribute to optimising medications that minimise PIM administration to patients with HF. In the future, PIMs for patients with HF may need to be monitored as a safety indicator.