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Association of early follow-up after acute myocardial infarction with higher rates of medication use.
Arch Intern Med. 2008 Mar 10; 168(5):485-91; discussion 492.AI

Abstract

BACKGROUND

Early outpatient follow-up after acute myocardial infarction (AMI) is recommended in guidelines, but its relationship with the use of evidence-based therapies is unknown.

METHODS

We evaluated 1516 patients hospitalized with AMI from the multicenter Prospective Registry Evaluating Outcomes After Myocardial Infarction: Events and Recovery registry. Early follow-up was defined as patient- reported visits with a primary care physician or cardiologist within 1 month after discharge. The primary outcomes were use of aspirin, beta-blockers, angiotensin-converting enzyme inhibitors, and statins in eligible patients at 6 months. Multivariable analyses assessed the association between early follow-up and medication use at 6 months, adjusting for patient and clinical characteristics. Secondary analyses compared medication use at 6 months for patients receiving collaborative follow-up from a single provider vs those receiving follow-up from both provider types.

RESULTS

Among the cohort, 34% reported no outpatient follow-up during the month following discharge. Rates of medication prescription among appropriate candidates were similar at hospital discharge for both follow-up groups. Compared with those not receiving early follow-up, those receiving early follow-up were more likely to be prescribed beta-blockers (80.1% vs 71.3%; P = .001), aspirin (82.9% vs 77.1%; P = .01), or statins (75.9% vs 68.6%; P = .005) at 6 months. In multivariable analyses, a persistent relationship remained between early follow-up and beta-blocker use (risk ratio, 1.08; 95% confidence interval, 1.02-1.15). In secondary analyses, statin use was higher in patients receiving collaborative follow-up (risk ratio, 1.11; 95% confidence interval, 1.01-1.22).

CONCLUSIONS

Early outpatient follow-up and collaborative follow-up after AMI is associated with higher rates of evidence-based medication use. Although further studies should assess whether this relationship is causal, these results support current guideline recommendations for follow-up after AMI.

Authors+Show Affiliations

Department of Medicine,Division of Cardiology, University of Colorado Denver Health Sciences Center, Denver, CO, USA. stacie.daugherty@uchsc.eduNo affiliation info availableNo 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
Multicenter Study

Language

eng

PubMed ID

18332293

Citation

Daugherty, Stacie L., et al. "Association of Early Follow-up After Acute Myocardial Infarction With Higher Rates of Medication Use." Archives of Internal Medicine, vol. 168, no. 5, 2008, pp. 485-91; discussion 492.
Daugherty SL, Ho PM, Spertus JA, et al. Association of early follow-up after acute myocardial infarction with higher rates of medication use. Arch Intern Med. 2008;168(5):485-91; discussion 492.
Daugherty, S. L., Ho, P. M., Spertus, J. A., Jones, P. G., Bach, R. G., Krumholz, H. M., Peterson, E. D., Rumsfeld, J. S., & Masoudi, F. A. (2008). Association of early follow-up after acute myocardial infarction with higher rates of medication use. Archives of Internal Medicine, 168(5), 485-91; discussion 492. https://doi.org/10.1001/archinte.168.5.485
Daugherty SL, et al. Association of Early Follow-up After Acute Myocardial Infarction With Higher Rates of Medication Use. Arch Intern Med. 2008 Mar 10;168(5):485-91; discussion 492. PubMed PMID: 18332293.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of early follow-up after acute myocardial infarction with higher rates of medication use. AU - Daugherty,Stacie L, AU - Ho,P Michael, AU - Spertus,John A, AU - Jones,Philip G, AU - Bach,Richard G, AU - Krumholz,Harlan M, AU - Peterson,Eric D, AU - Rumsfeld,John S, AU - Masoudi,Frederick A, PY - 2008/3/12/pubmed PY - 2008/4/11/medline PY - 2008/3/12/entrez SP - 485-91; discussion 492 JF - Archives of internal medicine JO - Arch Intern Med VL - 168 IS - 5 N2 - BACKGROUND: Early outpatient follow-up after acute myocardial infarction (AMI) is recommended in guidelines, but its relationship with the use of evidence-based therapies is unknown. METHODS: We evaluated 1516 patients hospitalized with AMI from the multicenter Prospective Registry Evaluating Outcomes After Myocardial Infarction: Events and Recovery registry. Early follow-up was defined as patient- reported visits with a primary care physician or cardiologist within 1 month after discharge. The primary outcomes were use of aspirin, beta-blockers, angiotensin-converting enzyme inhibitors, and statins in eligible patients at 6 months. Multivariable analyses assessed the association between early follow-up and medication use at 6 months, adjusting for patient and clinical characteristics. Secondary analyses compared medication use at 6 months for patients receiving collaborative follow-up from a single provider vs those receiving follow-up from both provider types. RESULTS: Among the cohort, 34% reported no outpatient follow-up during the month following discharge. Rates of medication prescription among appropriate candidates were similar at hospital discharge for both follow-up groups. Compared with those not receiving early follow-up, those receiving early follow-up were more likely to be prescribed beta-blockers (80.1% vs 71.3%; P = .001), aspirin (82.9% vs 77.1%; P = .01), or statins (75.9% vs 68.6%; P = .005) at 6 months. In multivariable analyses, a persistent relationship remained between early follow-up and beta-blocker use (risk ratio, 1.08; 95% confidence interval, 1.02-1.15). In secondary analyses, statin use was higher in patients receiving collaborative follow-up (risk ratio, 1.11; 95% confidence interval, 1.01-1.22). CONCLUSIONS: Early outpatient follow-up and collaborative follow-up after AMI is associated with higher rates of evidence-based medication use. Although further studies should assess whether this relationship is causal, these results support current guideline recommendations for follow-up after AMI. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/18332293/Association_of_early_follow_up_after_acute_myocardial_infarction_with_higher_rates_of_medication_use_ DB - PRIME DP - Unbound Medicine ER -