Barriers to Adoption of Mineralocorticoid Receptor Antagonists in Patients With Heart Failure: A Mixed‐Methods Study

Abstract

Background--Mineralocorticoid receptor antagonists (MRAs) are the most underutilized pharmacotherapy for heart failure. Minimal data are available on the barriers to MRA adoption from the perspective of prescribing clinicians.

Mineralocorticoid receptor antagonist pattern of use in heart failure with reduced ejection fraction: findings from BIOSTAT‐CHF

“…Our data do not provide granularity on why patients have stopped the drug, but they may suggest that clinicians' perception of patients' status is likely to play a role in these decisions and is a potential target for intervention . Patient compliance cannot be assessed from our data, and compliance with treatments is a major issue, especially concerning MRAs . Notwithstanding, we may observe that potassium levels were higher in the group of patients with MRA prescription, which is an indirect sign of treatment adherence.…”

Obstacles to mineralocorticoid receptor antagonists in a community‐based heart failure population

“…With both our data and the data from the Swedish Heart Failure Registry concluding that there seems to be an undertreatment in patients with moderately reduced kidney function, we need to work harder to remove barriers for MRA use. Several barriers have been identified on patient‐, clinician‐, and system‐based levels and could be a good starting point to improve treatment.…”

Patient With Chronic Heart Failure. Rational Choice of Therapy

“…Попытка разобраться в причинах недостаточной фармакотерапии АМКР представлена в недавнем исследовании Sandesh D. и соавт. [7]. В нем впервые была предложена структура из 8 барьеров, ограничивающих применение АМКР в лечении ХСН в реальной практике.…”

“…Они относятся к трем группам: пациентам, врачам и самой системе здравоохранения. Устранение этих барьеров, по мнению авторов, возможно с помощью образования и обучения не только пациентов, но и врачей, в связи с недостаточной осведомленностью и тех, и других, а также разработки систем адекватного лабораторного контроля лечения [7].…”