| Regional and practice variation in adherence to guideline recommendations for secondary and primary prevention among outpatients with atherothrombosis or risk factors in the United States: a report from the REACH Registry. | |
| | |
MedLine Citation:
|
PMID: 19726929 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: To reduce atherothrombosis-related morbidity and mortality, implementation of guideline-recommended therapies for primary and secondary prevention is necessary. Few data are available for outpatients in actual clinical practice, especially those without known heart disease treated by physicians trained in different specialties across the geographic regions of the United States. METHODS: The REduction of Atherothrombosis for Continued Health (REACH) Registry compiled data on atherosclerosis risk factors and treatment in an office-based setting. A total of 25,686 outpatients in the United States aged > or =45 years with either established atherothrombotic disease (n = 19,069) or > or =3 atherosclerosis risk factors (n = 6617) were enrolled between 2003 and 2004. Preventive medication use was analyzed according to the geographic region and specialty of the treating physician. RESULTS: Across the United States, 82% of patients with known disease were receiving at least 1 antiplatelet therapy, 83% were receiving a lipid-lowering agent, 65% were receiving an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker (ARB), and 57% were receiving a beta-blocker; only 65% were on > or =3 of 4 of these classes of medications. For primary prevention, 62% were taking at least 1 antiplatelet agent, 77% were receiving a statin, 75% were receiving an angiotensin-converting enzyme inhibitor or ARB, and 79% were receiving > or =2 of 3 of these classes of drugs. Among physician specialties, cardiologists had the highest rates of prescribing > or =3 of 4 major classes of secondary prevention and > or =2 of 3 classes of primary prevention medications. Regionally, the Northeast had the highest and the South the lowest rates of utilization of prevention medications. CONCLUSIONS: Adherence to guideline-recommended preventive therapies in the outpatient setting was affected by patient characteristics, geographical region, and treating physician specialty. Novel approaches may be needed to improve the use of evidence-based, guideline-recommended therapies in these outpatient settings. |
| | |
Authors:
|
Amit Kumar; Gregg C Fonarow; Kim A Eagle; Alan T Hirsch; Robert M Califf; Mark J Alberts; William E Boden; P Gabriel Steg; Mingyuan Shao; Deepak L Bhatt; Christopher P Cannon; |
Related Documents
:
|
7095769 - A review of the use of electroconvulsive therapy. 3690489 - Belegaled: mental health and the law in the united states, 1986. 16549709 - Trends in malpractice premiums for dermatologists: results of a national survey. 7336719 - The international system of units (si)and medicine. 21464849 - Only for "purely scientific" institutions: the medical library association's exchange, ... 1644939 - Surgical anatomy of the nail unit. 3274759 - Evaluation of pediatric oncology objectives developed by the american association for c... 9512969 - Periodontal disease in elderly patients. 11217589 - Heart murmurs: are older male dental patients aware of their existence? |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Critical pathways in cardiology Volume: 8 ISSN: 1535-2811 ISO Abbreviation: Crit Pathw Cardiol Publication Date: 2009 Sep |
Date Detail:
|
Created Date: 2009-09-03 Completed Date: 2009-12-09 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 101165286 Medline TA: Crit Pathw Cardiol Country: United States |
Other Details:
|
Languages: eng Pagination: 104-11 Citation Subset: IM |
Affiliation:
|
Department of Hospital Medicine, University of Massachusetts Medical School, Worcester, MA, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adrenergic beta-Antagonists
/
therapeutic use Aged Ambulatory Care / standards* Angiotensin-Converting Enzyme Inhibitors / therapeutic use Coronary Artery Disease / drug therapy, mortality*, prevention & control* Drug Therapy, Combination Female Guideline Adherence* Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use Male Middle Aged Physician's Practice Patterns Platelet Aggregation Inhibitors / therapeutic use Practice Guidelines as Topic* Primary Prevention / standards Prognosis Registries Risk Assessment Severity of Illness Index Survival Analysis Treatment Outcome United States |
| Chemical | |
Reg. No./Substance:
|
0/Adrenergic beta-Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Platelet Aggregation Inhibitors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Low-risk acute heart failure patients: external validation of the Society of Chest Pain Center's rec...
Next Document: Improving outcomes in high-risk populations using REACH: an inpatient cardiac risk reduction program...