| Autor: |
Martyn, Trejeeve, Saef, Joshua, Khot, Umesh N, Brophy, Todd, Martinez, Kathryn A, West, Lucianne, Cari, Cristiani, Block-Beach, Hunter, Hohman, Jessica, Kapadia, Samir R, Tang, Wai Hong W, Babiuch, Christopher, Estep, Jerry, Starling, Randall |
| Zdroj: |
Circulation (Ovid); November 2022, Vol. 146 Issue: Supplement 1 pA9811-A9811, 1p |
| Abstrakt: |
Introduction:Health systems have had limited success in improving on the suboptimal use of medical therapy for heart failure (HF).Hypothesis:We sought to understand if Guideline-Directed Medical Therapy (GDMT) scoring in combination with EHR-based HF registry data could be utilized to delineate system factors associated with higher or lower GDMT scores.Methods:We performed a cross-sectional analysis of patients with ≥ 2 outpatient encounter for heart failure (HF) in the prior 24 months. Total GDMT score was based on the absence, presence, and dosage of pertinent medications (Fig.1). Multivariable logistic regression analysis of patient, provider, and acute utilization factors associated with GDMT score above the median was performed.Results:Among 6,454 HF patients who had a documented echocardiographic LVEF ≤40 in in the prior 24 months, we observed that having a GDMT score ≥ 4 was associated with having a HF physician encounter (OR:2.02, 95%CI: 1.77-2.32), having two cardiology visits (any sub-specialty) within the prior 12 months (OR: 1.44,95%CI: 1.26-1.65), fewer all-cause (OR: 0.91, 95%CI: 0.87-0.94) and HF-specific hospitalizations (OR:0.64, 95%CI: 0.53-0.75), and higher eGFR (OR: 1.18, 95%CI: 1.12-1.25) (Fig. 2).Conclusions:GDMT scoring that is embedded in an EHR-Based Heart Failure Registry can help to define system-specific system factors associated with, the use of optimal HF medical therapy. Connectivity to cardiology, particularly HF specialists, was independently associated with higher GDMT score in our health system. |
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