Document Detail


Effect of a training program for primary care physicians on the optimization of beta-blocker treatment in elderly patients with heart failure.
MedLine Citation:
PMID:  20515625     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION AND OBJECTIVES: Underuse of betablockers may contribute to elevated mortality in chronic heart failure. The aim of this study was to determine whether a specific interventional training program for primary care physicians would help optimize the use of beta-blockers in elderly chronic heart failure patients.
METHODS: This randomized comparative study included 627 patients aged 70 years or more who were discharged consecutively from 53 Spanish hospitals with a principal diagnosis of chronic heart failure. In total, 292 health-care centers in the catchment areas of these hospitals were randomly assigned to two groups: one group of 146 centers carried out an interventional training program on beta-blocker use for primary care physicians belonging to the centers assigned to training, and 146 centers served as a control group. The main outcome variable was the percentage of patients who were receiving a beta-blocker at the maximum or maximum tolerated dose 3 months after hospital discharge.
RESULTS: The patients' mean age was 78+/-5 years and 42% were women. There was no difference between the groups in demographic characteristics, clinical care, or treatment at discharge. The percentage of patients who received beta-blockers at the maximum tolerated dose 3 months after discharge was greater in the training group (49% vs. 38%; P=.014). Being treated in the training group was an independent predictor of receiving a beta-blocker at the MTD (odds ratio=2.46; 95% confidence interval, 1.29-4.69; P< .001).
CONCLUSIONS: Implementation of an interventional training program on beta-blocker treatment for primary care physicians improved the use of these medications in elderly chronic heart failure patients.
Authors:
Manuel Anguita Sánchez; Manuel Jiménez-Navarro; Marisa Crespo; Luis Alonso-Pulpón; Eduardo de Teresa; Alfonso Castro-Beiras; Eulàlia Roig; Remei Artigas; Antonio Zapata; Ignacio López de Ulibarri; Javier Muñiz;
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Revista española de cardiología     Volume:  63     ISSN:  1579-2242     ISO Abbreviation:  Rev Esp Cardiol     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-02     Completed Date:  2010-12-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0404277     Medline TA:  Rev Esp Cardiol     Country:  Spain    
Other Details:
Languages:  eng     Pagination:  677-85     Citation Subset:  IM    
Affiliation:
Servicio de Cardiología, Hospital Reina Sofía, Córdoba, España. manuelp.anguita.sspa@juntadeandalucia.es
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use*
Aged
Chronic Disease
Education, Medical*
Female
Heart Failure / drug therapy*
Humans
Male
Primary Health Care*
Single-Blind Method
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists
Investigator
Investigator/Affiliation:
Amparo Alvarez Auñón / ; Manuel Anguita Sánchez / ; Enrique de los Arcos / ; Vicente Arrarte Esteban / ; Juan Luis Bardají Mayor / ; José R Berrazueta Fernández / ; Vicente Bertomeu Martínez / ; David Bierge Valero / ; Ramón Bover Freire / ; Pedro Cabeza Láinez / ; Antonio Castro Fernández / ; David Cremer / ; Luis Antonio Fernández Lázaro / ; Luis de la Fuente Galván / ; Jorge Fuertes Alonso / ; José María García de Andoain / ; Bernardo García de la Villa / ; Juan Pedro García González / ; Antonio García Quintana / ; Diego Giménez Cervantes / ; José Javier Gómez Barrado / ; Ana B González Gómez Belda / ; Carlos Juanatey / ; Francisco González Llopis / ; Justo Guevara Zuazo / ; Julio Hernández Alfonso / ; Isidro Hernández Fernández / ; Enrique Iglesias Río / ; Teresa Lozano Palencia / ; Antonio Martín Santana / ; Luis Martínez Dolz / ; Matas González / ; Juan Mayordomo López / ; Eduardo Molina Laborda / ; Carmen Navarro Lostal / ; Julio Núñez Villota / ; José Antonio Ortiz de Murúa / ; Pedro Pabón Osuna / ; Domingo Pascual Figal / ; Luis Pastor Torres / ; Miguel Angel Pérez de Juan / ; Francesc Planas / ; Quintas Ovejero Laura / ; Alfonso del Río Ligorit / ; Miguel Angel Rodríguez García / ; Luis Rodríguez Padial / ; Eulalia Roig Minguell / ; Dolores Romero Caballero / ; César Romero Menor / ; Julia Roure Fernández / ; Luis Ruiz-Valdepeñas / ; Eugenio Sánchez Vega / ; Adriana Soto Priore /

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