Temporal trends in heart failure medication prescription in a population-based cohort study.


Journal

BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874

Informations de publication

Date de publication:
02 03 2021
Historique:
entrez: 3 3 2021
pubmed: 4 3 2021
medline: 20 5 2021
Statut: epublish

Résumé

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). 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. 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. 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.

Identifiants

pubmed: 33653753
pii: bmjopen-2020-043290
doi: 10.1136/bmjopen-2020-043290
pmc: PMC7929882
doi:

Substances chimiques

Adrenergic beta-Antagonists 0
Angiotensin Receptor Antagonists 0
Angiotensin-Converting Enzyme Inhibitors 0
Mineralocorticoid Receptor Antagonists 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e043290

Subventions

Organisme : Medical Research Council
ID : G0902393
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/M501633/2
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/K006584/1
Pays : United Kingdom
Organisme : Department of Health
ID : RP-PG-0407-10314
Pays : United Kingdom
Organisme : British Heart Foundation
ID : AA/18/6/24223
Pays : United Kingdom
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : Chief Scientist Office
Pays : United Kingdom
Organisme : Department of Health
ID : 05/40/04
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_PC_13041
Pays : United Kingdom

Informations de copyright

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Références

J Am Coll Cardiol. 2019 Jan 8;73(1):29-40
pubmed: 30621948
Circulation. 2015 Jan 6;131(1):34-42
pubmed: 25406305
Eur J Heart Fail. 2016 Aug;18(8):891-975
pubmed: 27207191
Clin Res Cardiol. 2017 Nov;106(11):923-932
pubmed: 28748266
Eur J Heart Fail. 2017 Sep;19(9):1119-1127
pubmed: 28008698
J Am Coll Cardiol. 2019 May 21;73(19):2365-2383
pubmed: 30844480
Eur Heart J. 2012 Jul;33(14):1787-847
pubmed: 22611136
Clin Res Cardiol. 2008 Apr;97(4):244-52
pubmed: 18046524
N Engl J Med. 1991 Aug 1;325(5):293-302
pubmed: 2057034
N Engl J Med. 1999 Sep 2;341(10):709-17
pubmed: 10471456
Eur Heart J. 2004 Sep;25(18):1614-9
pubmed: 15351160
Eur Heart J. 2001 Sep;22(17):1527-60
pubmed: 11492984
Eur Heart J. 2005 Jun;26(11):1115-40
pubmed: 15901669
Eur J Heart Fail. 2019 Oct;21(10):1197-1206
pubmed: 30618162
J Am Coll Cardiol. 2017 Aug 8;70(6):776-803
pubmed: 28461007
Pharmacotherapy. 2016 Feb;36(2):174-86
pubmed: 26841333
BMJ. 2016 Apr 20;353:i1855
pubmed: 27098105
Heart Fail Rev. 2016 Nov;21(6):675-697
pubmed: 27465132
J Public Health (Oxf). 2012 Mar;34(1):138-48
pubmed: 21795302
J Manag Care Spec Pharm. 2016 May;22(5):561-71
pubmed: 27123917
Neth Heart J. 2018 May;26(5):272-279
pubmed: 29564639
Eur J Heart Fail. 2008 Oct;10(10):933-89
pubmed: 18826876
J Am Med Inform Assoc. 2019 Dec 1;26(12):1545-1559
pubmed: 31329239
Int J Epidemiol. 2012 Dec;41(6):1625-38
pubmed: 23220717
Heart Fail Rev. 2019 Jul;24(4):461-472
pubmed: 30874955
Ups J Med Sci. 2019 Jan;124(1):65-69
pubmed: 30092697
Br J Clin Pharmacol. 2010 Jan;69(1):4-14
pubmed: 20078607

Auteurs

Alicia Uijl (A)

Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands a.uijl@umcutrecht.nl.
Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Institute of Health Informatics, University College London, London, UK.
Health Data Research UK, London, UK.

Ilonca Vaartjes (I)

Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.

S Denaxas (S)

Institute of Health Informatics, University College London, London, UK.
Health Data Research UK, London, UK.
The National Institute for Health Research University College London Hospitals Biomedical Research Centre, University College London, London, UK.
Alan Turing Institute, London, UK.

Harry Hemingway (H)

Institute of Health Informatics, University College London, London, UK.
Health Data Research UK, London, UK.
Alan Turing Institute, London, UK.

Anoop Shah (A)

Institute of Health Informatics, University College London, London, UK.
Health Data Research UK, London, UK.

J Cleland (J)

Robertson Centre for Biostatistics and Clinical Trials, University of Glasgow, Glasgow, UK.
National Heart and Lung Institute, Imperial College, London, UK.

Diederick Grobbee (D)

Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.

Arno Hoes (A)

Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.

Folkert W Asselbergs (FW)

Institute of Health Informatics, University College London, London, UK.
Health Data Research UK, London, UK.
Department of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, UK.

Stefan Koudstaal (S)

Institute of Health Informatics, University College London, London, UK.
Health Data Research UK, London, UK.
Department of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.

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