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Incremental effects of concurrent pharmacotherapeutic regimens for heart failure on hospitalizations and costs.
Ann Pharmacother. 2005 Nov; 39(11):1785-91.AP

Abstract

BACKGROUND

Inappropriate medication use in patients with heart failure (HF) presents challenges in providing optimal, evidence-based care.

OBJECTIVE

To evaluate the incremental differences of concurrent and persistent use of angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, loop diuretics, and digoxin on the one-year, all-cause risk of hospitalization and total healthcare costs associated with treatment of HF in patients enrolled in a managed care organization within the US.

METHODS

A retrospective database analysis was conducted spanning from January 1, 1997, to December 31, 1999. Multivariate regression methods were used to examine the association between treatment regimens and hospitalizations or costs after controlling for patient demographics and risk factors.

RESULTS

Of the 1903 patients meeting inclusion criteria, 32.3% (n = 615) received none of the 4 HF agents studied and were associated with a 2.5 times greater risk (p < or = 0.001) of hospitalization and 43.6% higher (p < or = 0.001) total costs compared with all other patients with HF. Comparatively, 13.9% (n = 264) utilized the HF medications investigated for at least 6 months. Of those with persistent use of > or =3 agents, approximate decreases in hospitalizations were noted of 80% (p < or = 0.001) and total costs of 70% (p < or = 0.001) relative to patients receiving no HF therapy.

CONCLUSIONS

A substantial portion of patients with HF may be receiving suboptimal pharmacotherapeutic care in real-world practice settings, potentially incurring large increases in hospitalizations and total costs. Quality improvement initiatives should seek to identify and manage those not being treated according to guideline recommendations.

Authors+Show Affiliations

College of Pharmacy, University of Arizona, Tucson, AZ 85721-0207, USA. skrepnek@pharmacy.arizona.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16219900

Citation

Skrepnek, Grant H., et al. "Incremental Effects of Concurrent Pharmacotherapeutic Regimens for Heart Failure On Hospitalizations and Costs." The Annals of Pharmacotherapy, vol. 39, no. 11, 2005, pp. 1785-91.
Skrepnek GH, Abarca J, Malone DC, et al. Incremental effects of concurrent pharmacotherapeutic regimens for heart failure on hospitalizations and costs. Ann Pharmacother. 2005;39(11):1785-91.
Skrepnek, G. H., Abarca, J., Malone, D. C., Armstrong, E. P., Shirazi, F. M., & Woosley, R. L. (2005). Incremental effects of concurrent pharmacotherapeutic regimens for heart failure on hospitalizations and costs. The Annals of Pharmacotherapy, 39(11), 1785-91.
Skrepnek GH, et al. Incremental Effects of Concurrent Pharmacotherapeutic Regimens for Heart Failure On Hospitalizations and Costs. Ann Pharmacother. 2005;39(11):1785-91. PubMed PMID: 16219900.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incremental effects of concurrent pharmacotherapeutic regimens for heart failure on hospitalizations and costs. AU - Skrepnek,Grant H, AU - Abarca,Jacob, AU - Malone,Daniel C, AU - Armstrong,Edward P, AU - Shirazi,Farshad M, AU - Woosley,Raymond L, Y1 - 2005/10/11/ PY - 2005/10/13/pubmed PY - 2006/2/16/medline PY - 2005/10/13/entrez SP - 1785 EP - 91 JF - The Annals of pharmacotherapy JO - Ann Pharmacother VL - 39 IS - 11 N2 - BACKGROUND: Inappropriate medication use in patients with heart failure (HF) presents challenges in providing optimal, evidence-based care. OBJECTIVE: To evaluate the incremental differences of concurrent and persistent use of angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, loop diuretics, and digoxin on the one-year, all-cause risk of hospitalization and total healthcare costs associated with treatment of HF in patients enrolled in a managed care organization within the US. METHODS: A retrospective database analysis was conducted spanning from January 1, 1997, to December 31, 1999. Multivariate regression methods were used to examine the association between treatment regimens and hospitalizations or costs after controlling for patient demographics and risk factors. RESULTS: Of the 1903 patients meeting inclusion criteria, 32.3% (n = 615) received none of the 4 HF agents studied and were associated with a 2.5 times greater risk (p < or = 0.001) of hospitalization and 43.6% higher (p < or = 0.001) total costs compared with all other patients with HF. Comparatively, 13.9% (n = 264) utilized the HF medications investigated for at least 6 months. Of those with persistent use of > or =3 agents, approximate decreases in hospitalizations were noted of 80% (p < or = 0.001) and total costs of 70% (p < or = 0.001) relative to patients receiving no HF therapy. CONCLUSIONS: A substantial portion of patients with HF may be receiving suboptimal pharmacotherapeutic care in real-world practice settings, potentially incurring large increases in hospitalizations and total costs. Quality improvement initiatives should seek to identify and manage those not being treated according to guideline recommendations. SN - 1060-0280 UR - https://www.unboundmedicine.com/medline/citation/16219900/Incremental_effects_of_concurrent_pharmacotherapeutic_regimens_for_heart_failure_on_hospitalizations_and_costs_ L2 - http://journals.sagepub.com/doi/full/10.1345/aph.1G124?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -