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Data were collected from electronic medical records. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification identified HF diagnosis, ADEs and frailty using hospital frailty risk score. Outcomes included utilisation of HF pharmacotherapy; polypharmacy; ADEs, falls, delirium, renal and impairment; and duration of hospitalisation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 439 (22.0% of TO HOME cohort) patients with undifferentiated HF, 284 (69.5%) had intermediate or high risk of frailty, and 412 (94%) took \u22651 HF pharmacotherapy, with 357 (81.3%) patients on loop diuretics. Patients with high frailty risk frequently continued beta\u2010blockers (70%) and discontinued renin\u2010angiotensin system inhibitors (57%). Most patients experienced polypharmacy (<jats:italic>n<\/jats:italic> =\u2009426, 97.0%). Renal impairment prevalence was 67%\u201376% across frailty groups. Increasing frailty risk (low, intermediate and high) was associated with increasing prevalence of ADEs (31%, 56% and 84%), falls (12%, 25% and 46%) and delirium (8%, 27% and 49%) and longer hospitalisation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Frailty, HF\u2010pharmacotherapy changes in hospital and ADEs were common among older inpatients with HF. The association of adverse outcomes according to frailty needs further investigation. Poor documentation of HF phenotype may be a barrier to medication optimisation in older inpatients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.16612","type":"journal-article","created":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T10:14:45Z","timestamp":1734603285000},"page":"249-259","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Prevalence of heart failure pharmacotherapy utilisation, frailty and adverse drug events among hospitalised adults older than 75\u2009years: a multicentre cross\u2010sectional study"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6764-3233","authenticated-orcid":false,"given":"Mai H.","family":"Duong","sequence":"first","affiliation":[{"name":"Laboratory of Ageing and Pharmacology Kolling Institute, Northern Sydney Local Health District  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health The University of Sydney  Sydney 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