J Palliat Med. 2026 Oct 19:10966218261498525. doi: 10.1177/10966218261498525. Online ahead of print.
ABSTRACT
BACKGROUND: Heart failure (HF) and Alzheimer's disease and related dementias (AD/ADRD) frequently co-occur, complicating medication management at the end of life.
METHODS: This secondary analysis included 1338 patients with HF and AD/ADRD across 12 hospices. HF was classified as a primary (n = 210) or secondary (n = 1128). HF-related medication use and discontinuation at hospice admission were characterized and compared by diagnosis primacy.
RESULTS: Prehospice use was highest for beta-blockers (44.0%), loop diuretics (32.4%), and renin-angiotensin-aldosterone system (RAAS) inhibitors (17.7%). Among patients with documented use, discontinuation was 91.2%-100% across medication classes, including beta-blockers (97.5%), loop diuretics (97.0%), and RAAS inhibitors (94.1%). Discontinuation did not differ by HF diagnostic primacy.
CONCLUSIONS: HF-related medication discontinuation was common at hospice admission among patients with HF and AD/ADRD, regardless of HF diagnostic primacy. Further research is needed to understand the clinical rationale and symptom outcomes associated with medication discontinuation in hospice.
PMID:42897830 | DOI:10.1177/10966218261498525