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Use of disease-modifying therapies in patients hospitalized with heart failure: a population-based perspective.
Am J Med. 2007 Jan; 120(1):98.e1-8.AJ

Abstract

BACKGROUND

Little data are available about the hospital management of patients with decompensated heart failure (HF) with individual and combination medical therapies, particularly from the more generalizable perspective of a population-based investigation. The purpose of our study was to describe the use of different cardiac medications in 2463 patients with new-onset HF who were discharged from all greater Worcester, Massachusetts, hospitals during 2000.

METHODS

On the basis of a review of medical records, we examined the prescribing of 2 classes of cardiac medications that have been shown to improve the long-term prognosis of patients with HF (angiotensin pathway inhibitors and beta-blockers). We also examined the use of 2 therapies commonly used to improve the symptomatic status of patients with acute HF (diuretics and digoxin).

RESULTS

The mean age of the study sample was 76 years, and 57% were women. Approximately 1 in 5 patients were not prescribed beta-blockers or angiotensin inhibitors during their index hospitalization, whereas 1 in 3 patients were discharged with both of these effective cardiac medications. Diuretics were prescribed for virtually all patients (98%), followed by the use of digoxin in approximately half of patients (48%). The receipt of both beta-blockers and angiotensin pathway inhibitors was associated with several demographic, medical history, and clinical factors. Patients treated with both effective cardiac medications were also more likely to be counseled to monitor or modify several lifestyle factors that have been shown to be effective adjuncts to the medical management of patients with HF.

CONCLUSIONS

Considerable opportunity remains for the more optimal hospital management of patients with decompensated HF.

Authors+Show Affiliations

Department of Medicine, Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester, Mass, USA. Robert_Goldberg@brown.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

17208085

Citation

Goldberg, Robert J., et al. "Use of Disease-modifying Therapies in Patients Hospitalized With Heart Failure: a Population-based Perspective." The American Journal of Medicine, vol. 120, no. 1, 2007, pp. 98.e1-8.
Goldberg RJ, Spencer FA, Farmer C, et al. Use of disease-modifying therapies in patients hospitalized with heart failure: a population-based perspective. Am J Med. 2007;120(1):98.e1-8.
Goldberg, R. J., Spencer, F. A., Farmer, C., Lessard, D., Pezzella, S. M., & Meyer, T. E. (2007). Use of disease-modifying therapies in patients hospitalized with heart failure: a population-based perspective. The American Journal of Medicine, 120(1), e1-8.
Goldberg RJ, et al. Use of Disease-modifying Therapies in Patients Hospitalized With Heart Failure: a Population-based Perspective. Am J Med. 2007;120(1):98.e1-8. PubMed PMID: 17208085.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of disease-modifying therapies in patients hospitalized with heart failure: a population-based perspective. AU - Goldberg,Robert J, AU - Spencer,Frederick A, AU - Farmer,Cheryl, AU - Lessard,Darleen, AU - Pezzella,Stephen M, AU - Meyer,Theo E, PY - 2006/05/19/received PY - 2006/05/19/accepted PY - 2007/1/9/pubmed PY - 2007/2/9/medline PY - 2007/1/9/entrez SP - 98.e1 EP - 8 JF - The American journal of medicine JO - Am J Med VL - 120 IS - 1 N2 - BACKGROUND: Little data are available about the hospital management of patients with decompensated heart failure (HF) with individual and combination medical therapies, particularly from the more generalizable perspective of a population-based investigation. The purpose of our study was to describe the use of different cardiac medications in 2463 patients with new-onset HF who were discharged from all greater Worcester, Massachusetts, hospitals during 2000. METHODS: On the basis of a review of medical records, we examined the prescribing of 2 classes of cardiac medications that have been shown to improve the long-term prognosis of patients with HF (angiotensin pathway inhibitors and beta-blockers). We also examined the use of 2 therapies commonly used to improve the symptomatic status of patients with acute HF (diuretics and digoxin). RESULTS: The mean age of the study sample was 76 years, and 57% were women. Approximately 1 in 5 patients were not prescribed beta-blockers or angiotensin inhibitors during their index hospitalization, whereas 1 in 3 patients were discharged with both of these effective cardiac medications. Diuretics were prescribed for virtually all patients (98%), followed by the use of digoxin in approximately half of patients (48%). The receipt of both beta-blockers and angiotensin pathway inhibitors was associated with several demographic, medical history, and clinical factors. Patients treated with both effective cardiac medications were also more likely to be counseled to monitor or modify several lifestyle factors that have been shown to be effective adjuncts to the medical management of patients with HF. CONCLUSIONS: Considerable opportunity remains for the more optimal hospital management of patients with decompensated HF. SN - 1555-7162 UR - https://www.unboundmedicine.com/medline/citation/17208085/Use_of_disease_modifying_therapies_in_patients_hospitalized_with_heart_failure:_a_population_based_perspective_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9343(06)00679-6 DB - PRIME DP - Unbound Medicine ER -