Multifaceted intervention to promote β-blocker use in heart failure

LaPointe, Nancy M. Allen; DeLong, Elizabeth R.; Chen, Anita; Hammill, Bradley G.; Muhlbaier, Lawrence H.; Califf, Robert M.; Kramer, Judith M.

doi:10.1016/j.ahj.2005.06.038

Cited by 17 publications

(10 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, atenolol makes up approximately 40% of all BB use in our study sample, and others have also noted it to be the most commonly used BB in HF patients. [22][23][24] In addition, as a sensitivity analysis, we calculated adherence for all available BBs on the market at the time of the study, including those agents possessing intrinsic sympathomimetic activity (acebutolol and pindolol) that are not typically used for patients with heart failure. For the ACEI/ARB adherence analysis, all available ACEI or ARBs on the market at the time of the study were grouped to determine adherence.…”

Section: Discussionmentioning

confidence: 99%

Changes in Adherence to Evidence-Based Medications in the First Year After Initial Hospitalization for Heart Failure

Lamb

Eurich

McAlister

et al. 2009

Circ: Cardiovascular Quality and Outcomes

View full text Add to dashboard Cite

Background-The use of evidence-based medications in patients with heart failure has increased over the past 10 years.We aimed to determine whether adherence to these medications has also increased during this time. Methods and Results-A retrospective cohort was created using administrative databases from the province of Saskatchewan, Canada. Subjects discharged alive from their first hospitalization for heart failure between 1994 and 2003 were eligible. Those filling a prescription for a ␤-blocker (BB), angiotensin-converting enzyme inhibitor (ACEI), or angiotensin receptor blocker (ARB) within 6 months of discharge were followed for 1 year after the initial prescription. Of 8805 eligible patients, 67% of BB users (941/1414) and 74% of ACEI/ARB users (4441/5991) exhibited optimal adherence at 1 year (defined as Ն80% adherence calculated from pharmacy refill records). When grouped by year of initial heart failure hospitalization, the proportion of optimally adherent patients improved from 54% to 75% with BB and from 67% to 80% with ACEI/ARBs between 1994/1995 and 2002/2003 (P for trend Ͻ0.001 for both). Mean 1-year adherence improved from 71% to 83% for BB and 80% to 88% for ACEI/ARBs. After adjustment using multivariable logistic regression, subjects discharged in 2003 were significantly more likely to exhibit optimal adherence to a BB (odds ratio, 2.04; 95% CI, 1.21 to 3.44) or an ACEI/ARB (odds ratio, 1.65; 95% CI, 1.30 to 2.08) than those prescribed therapy in 1994/1995. Conclusions-One-year adherence to BB and ACEI/ARB is improving over time in patients discharged after first heart failure hospitalization. Patients taking multiple cardiac medications were not any less likely to exhibit optimal adherence than patients taking only 1 medication. (Circ Cardiovasc Qual Outcomes. 2009;2:228-235.)

show abstract

Section: Discussionmentioning

confidence: 99%

Changes in Adherence to Evidence-Based Medications in the First Year After Initial Hospitalization for Heart Failure

Lamb

Eurich

McAlister

et al. 2009

Circ: Cardiovascular Quality and Outcomes

View full text Add to dashboard Cite

show abstract

“…Strategies used in these initiatives have included passive dissemination of educational information to health care providers and patients, computerized order sets, automatically generated suggestions for care interventions, automated reminders attached to echocardiography results, as well as intensive education, direct feedback and care support from expert clinicians (161)(162)(163)(164)(165)(166)(167)(168)(169)(170)(171). Strategies that rely on passive dissemination of information to health care providers are, at best, modestly effective (162,167,168). More proscriptive strategies, either through computerized order sets or direct feedback and support from specialists, may be more successful.…”

Section: What Care Improvement Mechanisms Should Be Considered?mentioning

confidence: 99%

The 2010 Canadian Cardiovascular Society guidelines for the diagnosis and management of heart failure update: Heart failure in ethnic minority populations, heart failure and pregnancy, disease management, and quality improvement/assurance programs

Howlett¹,

McKelvie²,

Costigan³

et al. 2010

Canadian Journal of Cardiology

View full text Add to dashboard Cite

“…There must be a dissemination and implementation plan that follows basic principles of adult learning and quality control (9). Interventions might include elements of but are not limited to academic detailing, interactive workshop or learning programs, practical aids for clinical practice such as pocket or web-based reference guides, and individual practice chart audits.…”

Section: See Page 416mentioning

confidence: 99%

Performance Feedback

Howlett

2009

Journal of the American College of Cardiology

View full text Add to dashboard Cite

Multifaceted intervention to promote β-blocker use in heart failure

Cited by 17 publications

References 24 publications

Changes in Adherence to Evidence-Based Medications in the First Year After Initial Hospitalization for Heart Failure

Changes in Adherence to Evidence-Based Medications in the First Year After Initial Hospitalization for Heart Failure

The 2010 Canadian Cardiovascular Society guidelines for the diagnosis and management of heart failure update: Heart failure in ethnic minority populations, heart failure and pregnancy, disease management, and quality improvement/assurance programs

Performance Feedback

Contact Info

Product

Resources

About