TY - JOUR
T1 - Why do patients fail to receive β-blockers for chronic heart failure over time? A "real-world" single-center, 2-year follow-up experience of β-blocker therapy in patients with chronic heart failure
AU - Parameswaran, Anoop C.
AU - Tang, W. H Wilson
AU - Francis, Gary S.
AU - Gupta, Ritesh
AU - Young, James B.
N1 - Copyright:
Copyright 2010 Elsevier B.V., All rights reserved.
PY - 2005/5
Y1 - 2005/5
N2 - Background: The longitudinal pattern of β-blocker use in a heart-failure practice setting has not been explored. Previous studies have not specifically addressed the use of β-blockers over time to determine the rate of use and reasons for discontinuation. The long-term compliance rate for β-blocker drugs outside the context of a clinical trial has not been established. Methods: We prospectively followed a cohort of 500 consecutive patients between March and May 2001, with a clinical diagnosis of chronic heart failure seen in a specialized heart failure clinic and determined the longitudinal pattern of β-blocker use and clinical outcomes over a 2-year period. Results: The final cohort consists of 340 patients with a complete 2-year follow-up data (mean age 61 ± 14 years, 69% men, 53% with ischemic etiology, mean ejection fraction 27.6 ± 15%). At 6, 12, and 24 months, β-blocker utilization rates were maintained in 69%, 70%, and 74% of patients, respectively. Of the 120 confirmed initial non-β-blocker users, 28 (23%) were subsequently started on β-blocker, despite suspected relative contraindications in 53% of patients. Over a period of 2 years, the discontinuation rate was 10%, with failure to restart a β-blocker after hospitalization as the most common reason for β-blocker discontinuation. Conclusion: Utilization rates of β-blockers in our heart failure clinic have remained constant at approximately 70% throughout a 2-year follow-up. Of those who discontinued β-blockers (10%), the most common documented cause was failure to restart β-blockers after hospitalization.
AB - Background: The longitudinal pattern of β-blocker use in a heart-failure practice setting has not been explored. Previous studies have not specifically addressed the use of β-blockers over time to determine the rate of use and reasons for discontinuation. The long-term compliance rate for β-blocker drugs outside the context of a clinical trial has not been established. Methods: We prospectively followed a cohort of 500 consecutive patients between March and May 2001, with a clinical diagnosis of chronic heart failure seen in a specialized heart failure clinic and determined the longitudinal pattern of β-blocker use and clinical outcomes over a 2-year period. Results: The final cohort consists of 340 patients with a complete 2-year follow-up data (mean age 61 ± 14 years, 69% men, 53% with ischemic etiology, mean ejection fraction 27.6 ± 15%). At 6, 12, and 24 months, β-blocker utilization rates were maintained in 69%, 70%, and 74% of patients, respectively. Of the 120 confirmed initial non-β-blocker users, 28 (23%) were subsequently started on β-blocker, despite suspected relative contraindications in 53% of patients. Over a period of 2 years, the discontinuation rate was 10%, with failure to restart a β-blocker after hospitalization as the most common reason for β-blocker discontinuation. Conclusion: Utilization rates of β-blockers in our heart failure clinic have remained constant at approximately 70% throughout a 2-year follow-up. Of those who discontinued β-blockers (10%), the most common documented cause was failure to restart β-blockers after hospitalization.
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U2 - 10.1016/j.ahj.2004.07.026
DO - 10.1016/j.ahj.2004.07.026
M3 - Article
C2 - 15894978
AN - SCOPUS:19344369420
SN - 0002-8703
VL - 149
SP - 921
EP - 926
JO - American Heart Journal
JF - American Heart Journal
IS - 5
ER -