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Multimorbidity and Treatment-Related Outcomes in Older Heart Failure Patients

HSS Investigators: Mayra Tisminetzky, Jerry Gurwitz
Funding Agency: National Institute on Aging
Status: Ongoing

Project Overview: Heart failure (HF) is the most common reason for hospitalization in older adults. Over 85% of all patients hospitalized with HF are 65 years of age or older. Multimorbidity, usually defined as the presence of two or more chronic conditions, greatly increases the risk of hospitalization and mortality among older HF patients. In addition, the presence of multiple chronic conditions can greatly complicate the management of HF, especially with regard to pharmacotherapeutic decision-making. While national guidelines exist for the care of patients with HF, it is widely recognized that caution is required in applying established clinical practice guidelines to the care of older adults with multimorbidity, as practitioners are faced with managing not just a single condition, but multiple conditions simultaneously. In the proposed study, we will examine treatment patterns and the net benefits versus harms of selected therapies in patients presenting with HF and multimorbidity. The source population included over 100,000 members from four participating healthcare delivery systems within the Cardiovascular Research Network. Sites included Kaiser Permanente Northern California, Kaiser Permanente Northwest, Kaiser Permanente Southern California, and Fallon Health in Massachusetts. In addition, we will build a bridge to the new era of use of electronic health record data through natural language processing (NLP) technology. As an important, new, and novel approach, we will use NLP systems that will extract key information on adverse outcomes related to the therapies of interest in patients with HF and multimorbidity.  Learn more about this study here.

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