Temporal trends in heart failure medication prescription in a population-based cohort study
Objective We examined temporal heart failure (HF) prescription patterns in a large representative sample of real-world patients in the UK, using electronic health records (EHR).Methods From primary and secondary care EHR, we identified 85 732 patients with a HF diagnosis between 2002 and 2015. Almos...
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BMJ Publishing Group
2021-03-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/11/3/e043290.full |
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| author | Ilonca Vaartjes Harry Hemingway Anoop Shah Folkert W Asselbergs S Denaxas J Cleland Alicia Uijl Diederick Grobbee Arno Hoes Stefan Koudstaal |
| author_facet | Ilonca Vaartjes Harry Hemingway Anoop Shah Folkert W Asselbergs S Denaxas J Cleland Alicia Uijl Diederick Grobbee Arno Hoes Stefan Koudstaal |
| author_sort | Ilonca Vaartjes |
| collection | DOAJ |
| description | Objective We examined temporal heart failure (HF) prescription patterns in a large representative sample of real-world patients in the UK, using electronic health records (EHR).Methods From primary and secondary care EHR, we identified 85 732 patients with a HF diagnosis between 2002 and 2015. Almost 50% of patients with HF were women and the median age was 79.1 (IQR 70.2–85.7) years, with age at diagnosis increasing over time.Results We found several trends in pharmacological HF management, including increased beta blocker prescriptions over time (29% in 2002–2005 and 54% in 2013–2015), which was not observed for mineralocorticoid receptor-antagonists (MR-antagonists) (18% in 2002–2005 and 18% in 2013–2015); higher prescription rates of loop diuretics in women and elderly patients together with lower prescription rates of angiotensin-converting enzyme inhibitors and/or angiotensin II receptor blockers, beta blockers or MR-antagonists in these patients; little change in medication prescription rates occurred after 6 months of HF diagnosis and, finally, patients hospitalised for HF who had no recorded follow-up in primary care had considerably lower prescription rates compared with patients with a HF diagnosis in primary care with or without HF hospitalisation.Conclusion In the general population, the use of MR-antagonists for HF remained low and did not change throughout 13 years of follow-up. For most patients, few changes were seen in pharmacological management of HF in the 6 months following diagnosis. |
| format | Article |
| id | doaj-art-20dc76c4f03740f48ca7f3fbbb4387cc |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2021-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-20dc76c4f03740f48ca7f3fbbb4387cc2024-11-21T03:30:08ZengBMJ Publishing GroupBMJ Open2044-60552021-03-0111310.1136/bmjopen-2020-043290Temporal trends in heart failure medication prescription in a population-based cohort studyIlonca Vaartjes0Harry Hemingway1Anoop Shah2Folkert W Asselbergs3S Denaxas4J Cleland5Alicia Uijl6Diederick Grobbee7Arno Hoes8Stefan Koudstaal9Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The NetherlandsInternational Centre for Health and Society, Department of Epidemiology and Public Health, University College London Medical School, London WC1E 6BTHealth Data Research UK, London, UKDepartment of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, The NetherlandsInstitute of Health Informatics, University College London, London, UKNational Heart and Lung Institute, Imperial College, London, UKJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The NetherlandsJulius Global Health, Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht, The NetherlandsJulius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The NetherlandsInstitute of Health Informatics, University College London, London, UKObjective We examined temporal heart failure (HF) prescription patterns in a large representative sample of real-world patients in the UK, using electronic health records (EHR).Methods From primary and secondary care EHR, we identified 85 732 patients with a HF diagnosis between 2002 and 2015. Almost 50% of patients with HF were women and the median age was 79.1 (IQR 70.2–85.7) years, with age at diagnosis increasing over time.Results We found several trends in pharmacological HF management, including increased beta blocker prescriptions over time (29% in 2002–2005 and 54% in 2013–2015), which was not observed for mineralocorticoid receptor-antagonists (MR-antagonists) (18% in 2002–2005 and 18% in 2013–2015); higher prescription rates of loop diuretics in women and elderly patients together with lower prescription rates of angiotensin-converting enzyme inhibitors and/or angiotensin II receptor blockers, beta blockers or MR-antagonists in these patients; little change in medication prescription rates occurred after 6 months of HF diagnosis and, finally, patients hospitalised for HF who had no recorded follow-up in primary care had considerably lower prescription rates compared with patients with a HF diagnosis in primary care with or without HF hospitalisation.Conclusion In the general population, the use of MR-antagonists for HF remained low and did not change throughout 13 years of follow-up. For most patients, few changes were seen in pharmacological management of HF in the 6 months following diagnosis.https://bmjopen.bmj.com/content/11/3/e043290.full |
| spellingShingle | Ilonca Vaartjes Harry Hemingway Anoop Shah Folkert W Asselbergs S Denaxas J Cleland Alicia Uijl Diederick Grobbee Arno Hoes Stefan Koudstaal Temporal trends in heart failure medication prescription in a population-based cohort study BMJ Open |
| title | Temporal trends in heart failure medication prescription in a population-based cohort study |
| title_full | Temporal trends in heart failure medication prescription in a population-based cohort study |
| title_fullStr | Temporal trends in heart failure medication prescription in a population-based cohort study |
| title_full_unstemmed | Temporal trends in heart failure medication prescription in a population-based cohort study |
| title_short | Temporal trends in heart failure medication prescription in a population-based cohort study |
| title_sort | temporal trends in heart failure medication prescription in a population based cohort study |
| url | https://bmjopen.bmj.com/content/11/3/e043290.full |
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