Medical therapy following hospitalization for heart failure with reduced ejection fraction and association with discharge to long-term care: a cross-sectional analysis of the REasons for Geographic And Racial Differences in Stroke (REGARDS) population

Autor: Melissa K Van Dyke, Todd M. Brown, Karen C. Albright, Justin Blackburn, J. David Rhodes, Ligong Chen, Meredith L. Kilgore, Monika M. Safford, Olusola Olubowale, Emily B. Levitan, Oluwole Adegbala, Raegan W. Durant
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Male
lcsh:Diseases of the circulatory (Cardiovascular) system
Time Factors
Angiotensin-Converting Enzyme Inhibitors
030204 cardiovascular system & hematology
0302 clinical medicine
030212 general & internal medicine
Practice Patterns
Physicians'
Stroke
Mineralocorticoid Receptor Antagonists
education.field_of_study
Ejection fraction
Medical record
Prognosis
3. Good health
Hospitalization
Survival Rate
Drug Therapy
Combination
Female
Cardiology and Cardiovascular Medicine
Research Article
medicine.drug
medicine.medical_specialty
Adrenergic beta-Antagonists
Population
Heart failure
Drug Prescriptions
Angiotensin Receptor Antagonists
03 medical and health sciences
Long-term care
medicine
Humans
Medical prescription
Intensive care medicine
education
Aged
Retrospective Studies
business.industry
Racial Groups
Cardiovascular Agents
Stroke Volume
medicine.disease
United States
Cross-Sectional Studies
lcsh:RC666-701
Emergency medicine
Quality of Life
Therapy
Morbidity
Isosorbide dinitrate
business
Zdroj: BMC Cardiovascular Disorders, Vol 17, Iss 1, Pp 1-9 (2017)
BMC Cardiovascular Disorders
ISSN: 1471-2261
Popis: Background Less intensive treatment for heart failure with reduced ejection fraction (HFrEF) may be appropriate for patients in long-term care settings because of limited life expectancy, frailty, comorbidities, and emphasis on quality of life. Methods We compared treatment patterns between REasons for Geographic And Racial Differences in Stroke (REGARDS) study participants discharged to long-term care versus home following HFrEF hospitalizations. We examined medical records and Medicare pharmacy claims for 147 HFrEF hospitalizations among 80 participants to obtain information about discharge disposition and medication prescriptions and fills. Results Discharge to long-term care followed 22 of 147 HFrEF hospitalizations (15%). Participants discharged to long-term care were more likely to be prescribed beta-blockers and less likely to be prescribed aldosterone receptor antagonists and hydralazine/isosorbide dinitrate (96%, 14%, and 5%, respectively) compared to participants discharged home (81%, 22%, and 23%, respectively). The percentages of participants discharged to long-term care and home who had claims for filled prescriptions were similar for beta-blockers (68% versus 66%) and angiotensin converting enzyme inhibitors or angiotensin receptor blockers (ACEI/ARBs) (45% versus 47%) after 1 year. Smaller percentages of participants discharged to long-term care had claims for filled prescriptions of other medications compared to participants discharged home (diuretics: long-term care-50%, home-72%; hydralazine/isosorbide dinitrate: long-term care-5%, home-23%; aldosterone receptor antagonists: long-term care-5%, home-23%). Conclusions Differences in medication prescriptions and fills among individuals with HFrEF discharged to long-term care versus home may reflect prioritization of some medical therapies over others for patients in long-term care.
Databáze: OpenAIRE
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