Document Detail


Use of guideline-recommended therapies for heart failure in the Medicare population.
MedLine Citation:
PMID:  20641116     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Most information about the use of guideline-recommended therapies for heart failure reflects what occurred at discharge after an inpatient stay. HYPOTHESIS: Using a nationally representative, community-dwelling sample of elderly Medicare beneficiaries, we examined how the use of angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and beta-blockers has changed and factors associated with their use. METHODS: Using data from the Medicare Current Beneficiary Survey cost and use files matched with Medicare claims data, we identified beneficiaries for whom a diagnosis of heart failure was reported between January 1, 2000, and December 31, 2004. Data on medications prescribed during the year of cohort entry were based on patient self-report. We used multivariable logistic regression to explore relationships between the use of ACE inhibitors/ARBs and beta-blockers and patient demographic characteristics. RESULTS: From 2000 through 2004, the use of ARBs increased from 12% to 19%, and the use of beta-blockers increased from 30% to 41%. The use of ACE inhibitors remained constant at 45%. Beneficiaries who reported having prescription drug insurance coverage were 32% more likely than other beneficiaries to have filled a prescription for an ACE inhibitor or ARB and 26% more likely to have filled a prescription for a beta-blocker. CONCLUSIONS: Although the use of guideline-recommended therapies for heart failure has increased, it remains suboptimal.
Authors:
Lisa D DiMartino; Alisa M Shea; Adrian F Hernandez; Lesley H Curtis
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Clinical cardiology     Volume:  33     ISSN:  1932-8737     ISO Abbreviation:  Clin Cardiol     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-19     Completed Date:  2010-10-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  400-5     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 Wiley Periodicals, Inc.
Affiliation:
Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina 27715, USA.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use
Aged
Angiotensin II Type 1 Receptor Blockers / therapeutic use
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Cardiovascular Agents / therapeutic use*
Drug Prescriptions / statistics & numerical data
Drug Utilization / statistics & numerical data
Female
Guideline Adherence
Health Care Surveys
Heart Failure / drug therapy*
Humans
Insurance, Pharmaceutical Services / statistics & numerical data
Logistic Models
Male
Medicare / statistics & numerical data*
Physician's Practice Patterns / statistics & numerical data*
Practice Guidelines as Topic
Risk Assessment
Risk Factors
Treatment Outcome
United States
Grant Support
ID/Acronym/Agency:
R01AG026038/AG/NIA NIH HHS
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Cardiovascular Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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