Authors
Joffe, Samuel W.DeWolf, Matthew
Shih, Jeffrey
McManus, David D.
Spencer, Frederick A.
Lessard, Darleen M.
Gore, Joel M.
Goldberg, Robert J.
UMass Chan Affiliations
Meyers Primary Care InstituteDepartment of Medicine, Division of Cardiovascular Medicine
Department of Quantitative Health Sciences
Document Type
Journal ArticlePublication Date
2013-06-01Keywords
Heart FailureCardiology
Cardiovascular Diseases
Epidemiology
Health Services Research
Pharmaceutical Preparations
Public Health
Therapeutics
Metadata
Show full item recordAbstract
BACKGROUND: Despite the availability of effective therapies, heart failure (HF) remains a highly prevalent disease and the leading cause of hospitalizations in the U.S. Few data are available, however, describing changing trends in the use of various cardiac medications to treat patients with HF and factors associated with treatment. The objectives of this population-based study were to examine decade-long trends (1995 - 2004) in the use of several cardiac medications in patients hospitalized with acute decompensated heart failure (ADHF) and factors associated with evidence-based treatment. METHODS: We reviewed the medical records of 9,748 residents of the Worcester, MA, metropolitan area who were hospitalized with ADHF at all 11 central Massachusetts medical centers in 1995, 2000, 2002, and 2004. RESULTS: Between 1995 and 2004, respectively, the prescription upon hospital discharge of beta-blockers (23%; 67%), angiotensin pathway inhibitors (47%; 55%), statins (5%; 43%), and aspirin (35%; 51%) increased markedly, while the use of digoxin (51%; 29%), nitrates (46%; 24%), and calcium channel blockers (33%; 22%) declined significantly; nearly all patients received diuretics. Patients in the earliest study year, those with a history of obstructive pulmonary disease or anemia, incident HF, non-specific symptoms, and women were less likely to receive beta blockers and angiotensin pathway inhibitors than respective comparison groups. In 2004, 82% of patients were discharged on at least one of these recommended agents; however, only 41% were discharged on medications from both recommended classes. CONCLUSIONS: Our data suggest that opportunities exist to further improve the use of HF therapeutics.Source
J Clin Med Res. 2013 Jun;5(3):194-204. doi: 10.4021/jocmr1376w. Epub 2013 Apr 23. Link to article on publisher's site
DOI
10.4021/jocmr1376wPermanent Link to this Item
http://hdl.handle.net/20.500.14038/30157PubMed ID
23671545Related Resources
Rights
Copyright 2013, Joffe et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.ae974a485f413a2113503eed53cd6c53
10.4021/jocmr1376w