Heart failure & cardiomyopathiesCohort study
Magnitude of and outcome associated with inappropriate prescribing in heart failure with reduced ejection fraction: an analysis of 50 348 patients from the Swedish Heart Failure Registry
- Registry-based cohort study
- Swedish HF Registry
- real-world
Authors' conclusion
Nearly half of HFrEF patients received PIP medications, particularly those with multimorbidity, which was independently associated with worse outcomes and less GDMT use.
Study context
- Population
- Patients with Heart Failure and Reduced Ejection Fraction (HFrEF) in the Swedish HF Registry, 2005–20
- Participants
- 50,348 patients
- Exposure
- ≥1 potentially inappropriate prescribing (PIP) vs no PIP
- PIPn = 23,583
- Outcome
- Prevalence, predictors and outcomes of PIP
Main finding
As reported in the abstract
Prevalence of ≥1 PIP
≥1 PIP
47%
23 583 events
- Neuroleptics
- 29%
- Systemic steroids
- 10%
- NSAIDs
- 6%
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| Independent predictors of PIP — Rheumatoid arthritis vs No PIP | 3.39 (2.92–3.94) | |
| Independent predictors of PIP — Depression vs No PIP | 3.06 (2.74–3.42) | |
| Independent predictors of PIP — Chronic obstructive pulmonary disease vs No PIP | 1.86 (1.76–1.98) | |
| Independent predictors of PIP — Gout vs No PIP | 1.48 (1.35–1.62) | |
| 0.20.5125Odds ratio (log scale) |
Most frequent PIP agents
- Neuroleptics
- 29%
- Systemic steroids
- 10%
- NSAIDs
- 6%
GDMT use
- Patients on PIP were less likely to receive GDMT
Original publication
Magnitude of and outcome associated with inappropriate prescribing in heart failure with reduced ejection fraction: an analysis of 50 348 patients from the Swedish Heart Failure Registry. Eur J Heart Fail. Published 14 January 2026. doi:10.1093/ejhf/xuaf026
Summarised from the published abstract; every number is checked against it