Polypharmacy in heart failure: A growing challenge

Current guidelines in heart failure recommend ‘add-on’ prescribing of evidence-based medicines aimed at improving symptoms and prognosis. Heart failure patients therefore commonly receive multiple drug therapies and this ‘polypharmacy’ is set to increase with the recognition of new potential drug targets. Drug regimes in heart failure are further complicated by increasing age and high levels of comorbidity inherent in this patient group. Nurses are central to the patient's care pathway and the commencement and titration of medicines are key component sof the patient's management plan. The development of nursing specialism in heart failure alongside independent prescribing have further extended nurse's responsibilities. Polypharmacy is an important consideration for nursing and this article provides an overview of the development of drug therapies in heart failure as well as the scope of polypharmacy for this group. The key implications of polypharmacy in heart failure will be explored, including side effects, drug interactions, prescription errors, optimal clinical prescribing and patient adherence.