Use of Guideline-Recommended Therapies for Heart Failure in the Medicare Population

作者：DiMartino Lisa D; Shea Alisa M; Hernandez Adrian F; Curtis Lesley H^*

来源：Clinical Cardiology, 2010, 33(7): 400-405.

DOI：10.1002/clc.20760

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.

• 出版日期2010-7