Potentially inappropriate use of furosemide in a very elderly population: An observational study. Issue 8 (15th June 2017) - Rodriguez‐Cillero, Carla
Summary: Objective: Little is known about furosemide prescription modalities in elderly people. We describe furosemide prescription in ambulatory elderly patients. Methods: All patients aged over 80 years, affiliated to Mutualité Sociale Agricole de Bourgogne, a French regional health insurance plan, with a medical prescription delivered in March 2015, were retrospectively included. Results: Among 15 141 patients with a median age of 86 years, comprising 61.3% of women, 3937 patients (26%) had a prescription for furosemide. Severe heart failure was the most common chronic comorbidity (27.7%). Furosemide was considered a long‐term therapy for almost all patients (98.7% with prescriptions for 3 months or more). Recommended indications for long‐term furosemide therapy included severe heart failure (50.9%), chronic nephropathy (3%) and cirrhosis (0.1%). The furosemide prescription rate increased with age (81‐85: 20.4%, 86‐90: 28.5%, 91‐95: 35.6%, >95: 42.7%, P <.001), and the increase was associated with a decrease in recommended heart failure therapeutics (beta‐blockers, angiotensin‐conversion‐enzyme‐inhibitors or angiotensin‐receptor‐blockers). Prescribers were mostly general practitioners (81.3%). Plasma electrolytes were controlled in less than a half of the patients with furosemide. Conclusions: In this large study, long‐course furosemide was prescribed in a quarter of ambulatory patients. Half of those taking furosemide suffered from severe heart failure. Age was associated with a linear increase in furosemide use and a decrease in recommended heart failure therapeutic prescriptions. A large part of these prescriptions do not seem to be in accordance with recommendations.