Key result
Patient and physician characteristics were associated with the prescription of recommended heart failure drugs, with overall prescription rates of 50% for ACEI/ARBs and 39% for beta blockers.
Observational (n=708)
Yes
Prescription of guideline-directed medical therapy for heart failure in primary care is suboptimal and influenced by both patient and physician characteristics.
Suboptimal primary care GDMT rates warrant caution in assuming optimal implementation; leaves open targeted interventions on patient and physician factors.
BACKGROUND: Translating the findings from heart failure drug trials into clinical practice has been shown to take time. For the generation of a primary care guideline that takes preferences of general practitioners (GPs) and characteristics of their patients into account, it is necessary to identify the associations between patient and physician characteristics with the prescription of the recommended drugs. METHODS: We searched for patients with chronic heart failure in the electronic patient records of 14 GPs. In multivariate analyses, we examined the prognostic value of patient and physician characteristics for the prescriptions. RESULTS: In the 708 identified patients with chronic heart failure, prescription rates for angiotensin converting enzyme inhibitors/angiotensin receptor blockers, beta blockers, diuretics, digitalis and aldosterone antagonists were 50%, 39%, 56%, 35%, and 4%, respectively. On the patient level, age, disease severity, comorbidities and concomitant drug intake were differently related to the prescriptions. On the physician level, age, years of clinical experience and organisation of the practice itself played a differentiating role. conclusion: Our study demonstrates associations between patient and physician characteristics with the prescription of the recommended drugs that should be taken into account to translate guideline recommendations for application in general practice.
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Koschack et al. (2009) conducted an observational in chronic heart failure (n=708). Patient and physician characteristics was evaluated on Prescription of recommended heart failure drugs. Patient and physician characteristics were associated with the prescription of recommended heart failure drugs, with overall prescription rates of 50% for ACEI/ARBs and 39% for beta blockers.
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