Nonprescription medication use in patients with heart failure: assessment methods, utilization patterns, and discrepancies with medical records

Background: The use of over-the-counter products, herbals, and vitamins or supplements (collectively termed "nonprescription medications") is common among individuals with cardiovascular disease. We sought to determine patterns and predictors of nonprescription medication use and assessed whether different survey methodology may result in variable patient reporting of these products.

Methods and results: We surveyed 161 patients with heart failure. The first 80 participants were provided a written survey to complete during their clinic appointment, and the next 80 age-matched participants met with study personnel for survey administration via face-to-face interview. Over-the-counter product use was reported by 88% of participants, whereas 34.8% took herbal supplements, and 65.2% took vitamins or supplements. Users of nonprescription medications were older, more likely to have an ischemic etiology, and concomitant chronic conditions. No differences in reporting were noted for patient versus provider-administered surveys. Discrepancies between survey and medical record data were common (40.4%), occurring most frequently with nonprescription aspirin, proton pump inhibitors, magnesium, and acetaminophen.

Conclusions: The majority of study participants used nonprescription medications, and often did not report usage to health care providers. Patient education regarding importance of disclosure of nonprescription medications is crucial, as is consistent querying of use by heart failure providers.