Medication Initiation Burden Required to Comply With Heart Failure Guideline Recommendations and Hospital Quality Measures
Key result
A quarter of patients hospitalized with heart failure need to start >1 medication to meet quality measures, with actual new prescriptions (mean 1.16) lagging behind indications (mean 1.45).
Population
158,922 patients with a primary discharge diagnosis of heart failure from 271 hospitals
Comparison
Assessment of eligibility for new prescriptions… vs Patient's medication regimen at hospital admission
Design
Cohort
Authors
Discussion
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Member takes
Implication
Persistent gaps in indicated HF medication initiation warrant clinician attention; leaves open whether targeted interventions improve quality measure adherence.
Study Design
Type
Observational (n=158,922)
Multicenter
Yes
Structured PICO
P
Population
158,922 patients from 271 hospitals with a primary discharge diagnosis of heart failure, assessed for medication initiation burden.
E
Exposure
Assessment of eligibility for new prescriptions of guideline-directed medical therapy (angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, β-blockers, aldosterone antagonists, hydralazine/isosorbide dinitrate, and anticoagulants) at hospital discharge
C
Comparator
Patient's medication regimen at hospital admission
O
Outcome
Difference between a patient's medication regimen at hospital admission and that recommended by HF quality measures at discharge (medication initiation burden)
Main Result
Absolute Event Rate: 1.45% vs 1.16%
A significant proportion of patients hospitalized for heart failure require the initiation of multiple new medications at discharge to meet guideline recommendations, highlighting the need for systems to manage polypharmacy and transitional care.
Cite This Study
Allen et al. (2015) conducted an observational in Heart failure (n=158,922). Guideline-directed medical therapy indications vs. Actual new prescriptions was evaluated on Number of new medications indicated vs actually prescribed. A quarter of patients hospitalized with heart failure need to start >1 medication to meet quality measures, with actual new prescriptions (mean 1.16) lagging behind indications (mean 1.45).