Utilization of Digoxin among Hospitalized Older Patients with Heart Failure and Atrial Fibrillation in Thailand: Prevalence, Associated Factors, and Clinical Outcomes
Background Digoxin is used to control heart rate in patients with heart failure (HF) and atrial fibrillation (AF). However, its use is often limited in older patients, as they are prone to digoxin toxicity. This study aimed to determine the prevalence of digoxin use, investigate the factors associat...
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| Format: | Article |
| Language: | English |
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Korea Geriatrics Society
2021-12-01
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| Series: | Annals of Geriatric Medicine and Research |
| Subjects: | |
| Online Access: | http://www.e-agmr.org/upload/pdf/agmr-21-0098.pdf |
| _version_ | 1818943432073150464 |
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| author | Noppaket Singkham Yuttana Wongsalap Duangkamon Poolpun Sirichok Phetnoo Chuthalak Somkhon |
| author_facet | Noppaket Singkham Yuttana Wongsalap Duangkamon Poolpun Sirichok Phetnoo Chuthalak Somkhon |
| author_sort | Noppaket Singkham |
| collection | DOAJ |
| description | Background Digoxin is used to control heart rate in patients with heart failure (HF) and atrial fibrillation (AF). However, its use is often limited in older patients, as they are prone to digoxin toxicity. This study aimed to determine the prevalence of digoxin use, investigate the factors associated with digoxin use, and explore the association between digoxin use and clinical outcomes in older Thai patients with HF and AF. Methods This cross-sectional study used data obtained from an electronic medical records database. We performed logistic regression analysis to determine the prevalence of digoxin use at index discharge and the factors associated with its use. The Cox proportional hazard model was used to determine the association of all-cause mortality and HF rehospitalization with digoxin use. Results Of the 640 patients assessed, 107 (16.72%) were prescribed digoxin before discharge. The factors negatively associated with digoxin use included high serum creatinine level (adjusted odds ratio [AOR]=0.38; 95% confidence interval [CI], 0.22–0.65) and ischemic heart disease (IHD) (AOR=0.52; 95% CI, 0.30–0.88). The factors positively associated with digoxin use were the use of diuretics (AOR=2.65; 95% CI, 1.60–4.38) and mineralocorticoid receptor antagonists (MRAs) (AOR=2.24; 95% CI, 1.18–4.27). We observed no significant association between digoxin use and clinical outcomes (adjusted hazard ratio=1.00; 95% CI, 0.77–1.30). Conclusion Digoxin use was prevalent among older patients with HF and AF. Patients with high serum creatinine or IHD were less likely to be prescribed digoxin, whereas those using diuretics or MRAs were more likely to be prescribed digoxin. Although digoxin use was not uncommon among older patients, it was prescribed with caution among Thai patients hospitalized with HF and AF. |
| first_indexed | 2024-12-20T07:27:14Z |
| format | Article |
| id | doaj.art-e6f0adc667cf4e9297135e775c87d924 |
| institution | Directory Open Access Journal |
| issn | 2508-4798 2508-4909 |
| language | English |
| last_indexed | 2024-12-20T07:27:14Z |
| publishDate | 2021-12-01 |
| publisher | Korea Geriatrics Society |
| record_format | Article |
| series | Annals of Geriatric Medicine and Research |
| spelling | doaj.art-e6f0adc667cf4e9297135e775c87d9242022-12-21T19:48:30ZengKorea Geriatrics SocietyAnnals of Geriatric Medicine and Research2508-47982508-49092021-12-0125426026810.4235/agmr.21.00981001Utilization of Digoxin among Hospitalized Older Patients with Heart Failure and Atrial Fibrillation in Thailand: Prevalence, Associated Factors, and Clinical OutcomesNoppaket Singkham0Yuttana Wongsalap1Duangkamon Poolpun2Sirichok Phetnoo3Chuthalak Somkhon4 Division of Pharmacy Practice, Department of Pharmaceutical Care, School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand Division of Pharmacy Practice, Department of Pharmaceutical Care, School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand Department of Pharmacy, Buddhachinaraj Hospital, Phitsanulok, Thailand Division of Pharmacy Practice, Department of Pharmaceutical Care, School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand Division of Pharmacy Practice, Department of Pharmaceutical Care, School of Pharmaceutical Sciences, University of Phayao, Phayao, ThailandBackground Digoxin is used to control heart rate in patients with heart failure (HF) and atrial fibrillation (AF). However, its use is often limited in older patients, as they are prone to digoxin toxicity. This study aimed to determine the prevalence of digoxin use, investigate the factors associated with digoxin use, and explore the association between digoxin use and clinical outcomes in older Thai patients with HF and AF. Methods This cross-sectional study used data obtained from an electronic medical records database. We performed logistic regression analysis to determine the prevalence of digoxin use at index discharge and the factors associated with its use. The Cox proportional hazard model was used to determine the association of all-cause mortality and HF rehospitalization with digoxin use. Results Of the 640 patients assessed, 107 (16.72%) were prescribed digoxin before discharge. The factors negatively associated with digoxin use included high serum creatinine level (adjusted odds ratio [AOR]=0.38; 95% confidence interval [CI], 0.22–0.65) and ischemic heart disease (IHD) (AOR=0.52; 95% CI, 0.30–0.88). The factors positively associated with digoxin use were the use of diuretics (AOR=2.65; 95% CI, 1.60–4.38) and mineralocorticoid receptor antagonists (MRAs) (AOR=2.24; 95% CI, 1.18–4.27). We observed no significant association between digoxin use and clinical outcomes (adjusted hazard ratio=1.00; 95% CI, 0.77–1.30). Conclusion Digoxin use was prevalent among older patients with HF and AF. Patients with high serum creatinine or IHD were less likely to be prescribed digoxin, whereas those using diuretics or MRAs were more likely to be prescribed digoxin. Although digoxin use was not uncommon among older patients, it was prescribed with caution among Thai patients hospitalized with HF and AF.http://www.e-agmr.org/upload/pdf/agmr-21-0098.pdffrail older adultsprevalencedrug utilizationdigoxinheart failureatrial fibrillation |
| spellingShingle | Noppaket Singkham Yuttana Wongsalap Duangkamon Poolpun Sirichok Phetnoo Chuthalak Somkhon Utilization of Digoxin among Hospitalized Older Patients with Heart Failure and Atrial Fibrillation in Thailand: Prevalence, Associated Factors, and Clinical Outcomes Annals of Geriatric Medicine and Research frail older adults prevalence drug utilization digoxin heart failure atrial fibrillation |
| title | Utilization of Digoxin among Hospitalized Older Patients with Heart Failure and Atrial Fibrillation in Thailand: Prevalence, Associated Factors, and Clinical Outcomes |
| title_full | Utilization of Digoxin among Hospitalized Older Patients with Heart Failure and Atrial Fibrillation in Thailand: Prevalence, Associated Factors, and Clinical Outcomes |
| title_fullStr | Utilization of Digoxin among Hospitalized Older Patients with Heart Failure and Atrial Fibrillation in Thailand: Prevalence, Associated Factors, and Clinical Outcomes |
| title_full_unstemmed | Utilization of Digoxin among Hospitalized Older Patients with Heart Failure and Atrial Fibrillation in Thailand: Prevalence, Associated Factors, and Clinical Outcomes |
| title_short | Utilization of Digoxin among Hospitalized Older Patients with Heart Failure and Atrial Fibrillation in Thailand: Prevalence, Associated Factors, and Clinical Outcomes |
| title_sort | utilization of digoxin among hospitalized older patients with heart failure and atrial fibrillation in thailand prevalence associated factors and clinical outcomes |
| topic | frail older adults prevalence drug utilization digoxin heart failure atrial fibrillation |
| url | http://www.e-agmr.org/upload/pdf/agmr-21-0098.pdf |
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