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Managed care patients with heart failure: spectrum of ventricular dysfunction and predictors of medication utilization.
J Card Fail 2005; 11(2):106-11JC

Abstract

BACKGROUND

Heart failure (HF) is a common clinical syndrome resulting in high morbidity and mortality. We examined the spectrum of ventricular dysfunction, and investigated the predictors of angiotensin-converting enzyme (ACE) inhibitor, beta-blocker, and spironolactone prescription in 1613 managed care patients with HF.

METHODS AND RESULTS

The diagnosis of HF was made by a HF discharge diagnosis or at least 3 physician encounters with a HF diagnosis during 2000. Logistic regression was used to identify predictors of medication prescription. Preserved systolic function was documented in 37%, moderate-severe systolic dysfunction in 31%, mild systolic in 14%, and 18% had inadequate documentation. The mean age was 69 years, 58% were women, 24% African American, and 60% were Medicare patients. Patients without HF type documented were the least aggressively treated. Coronary artery disease, hypertension, and diabetes predicted increased utilization of ACE inhibitor and beta-blocker therapies. History of nephropathy was associated with less ACE inhibitor prescription. Advancing age predicted less utilization of beta-blockers and spironolactone. Neither ethnicity nor gender influenced medication prescription.

CONCLUSION

Preserved left ventricular function was common. Documentation of significant systolic dysfunction was associated with improved quality of care. Interventions to encourage documentation of HF type and further study of HF with preserved systolic function are warranted.

Authors+Show Affiliations

Medical Review of North Carolina, Cary, North Carolina 27511-8598, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15732029

Citation

Sueta, Carla A., et al. "Managed Care Patients With Heart Failure: Spectrum of Ventricular Dysfunction and Predictors of Medication Utilization." Journal of Cardiac Failure, vol. 11, no. 2, 2005, pp. 106-11.
Sueta CA, Bertoni AG, Massing MW, et al. Managed care patients with heart failure: spectrum of ventricular dysfunction and predictors of medication utilization. J Card Fail. 2005;11(2):106-11.
Sueta, C. A., Bertoni, A. G., Massing, M. W., McArdle, J., Duren-Winfield, V., Davis, J., ... Goff, D. C. (2005). Managed care patients with heart failure: spectrum of ventricular dysfunction and predictors of medication utilization. Journal of Cardiac Failure, 11(2), pp. 106-11.
Sueta CA, et al. Managed Care Patients With Heart Failure: Spectrum of Ventricular Dysfunction and Predictors of Medication Utilization. J Card Fail. 2005;11(2):106-11. PubMed PMID: 15732029.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Managed care patients with heart failure: spectrum of ventricular dysfunction and predictors of medication utilization. AU - Sueta,Carla A, AU - Bertoni,Alain G, AU - Massing,Mark W, AU - McArdle,Jill, AU - Duren-Winfield,Vanessa, AU - Davis,Jennifer, AU - Croft,Janet B, AU - Goff,David C,Jr PY - 2005/2/26/pubmed PY - 2005/7/12/medline PY - 2005/2/26/entrez SP - 106 EP - 11 JF - Journal of cardiac failure JO - J. Card. Fail. VL - 11 IS - 2 N2 - BACKGROUND: Heart failure (HF) is a common clinical syndrome resulting in high morbidity and mortality. We examined the spectrum of ventricular dysfunction, and investigated the predictors of angiotensin-converting enzyme (ACE) inhibitor, beta-blocker, and spironolactone prescription in 1613 managed care patients with HF. METHODS AND RESULTS: The diagnosis of HF was made by a HF discharge diagnosis or at least 3 physician encounters with a HF diagnosis during 2000. Logistic regression was used to identify predictors of medication prescription. Preserved systolic function was documented in 37%, moderate-severe systolic dysfunction in 31%, mild systolic in 14%, and 18% had inadequate documentation. The mean age was 69 years, 58% were women, 24% African American, and 60% were Medicare patients. Patients without HF type documented were the least aggressively treated. Coronary artery disease, hypertension, and diabetes predicted increased utilization of ACE inhibitor and beta-blocker therapies. History of nephropathy was associated with less ACE inhibitor prescription. Advancing age predicted less utilization of beta-blockers and spironolactone. Neither ethnicity nor gender influenced medication prescription. CONCLUSION: Preserved left ventricular function was common. Documentation of significant systolic dysfunction was associated with improved quality of care. Interventions to encourage documentation of HF type and further study of HF with preserved systolic function are warranted. SN - 1071-9164 UR - https://www.unboundmedicine.com/medline/citation/15732029/Managed_care_patients_with_heart_failure:_spectrum_of_ventricular_dysfunction_and_predictors_of_medication_utilization_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S107191640400572X DB - PRIME DP - Unbound Medicine ER -