Full adherence to beta-blockers increased from 47% in 1996 to 57% in 2003, and to spironolactone from 31% to 42%, while adherence to angiotensin-system blockers remained unchanged at 54%.
Observational
Yes
What are the temporal trends in adherence to guideline-directed medical therapy (angiotensin-system blockers, beta-blockers, spironolactone) among elderly patients after hospitalization for heart failure?
Despite slight improvements in adherence to beta-blockers and spironolactone over time, overall nonadherence to heart failure medications remains high among elderly patients.
Although the complexity of treatment regimens for patients with heart failure (HF) has increased over time because of the increased availability of efficacious medications, little is known about temporal trends in adherence to treatment regimens in these patients. We assessed trends in adherence to angiotensin-system blockers (ABs), β-blockers (BBs), and spironolactone (SL) for HF in Medicare beneficiaries enrolled in two statewide pharmacy benefit programs from 1995 to 2004. The proportion of days covered (PDC) (%) was assessed after the first dispensing among users of an AB, BB, or SL. Proportions of full adherence (PDC >80%) did not change over time for ABs (54% in both 1996 and 2003) but increased slightly for BBs (from 47% in 1996 to 57% in 2003) and SL (from 31% in 1996 to 42% in 2003). Black race and dialysis treatment predicted poor adherence to any medications. Adherence to BBs and SL increased modestly over time, but overall nonadherence remained high.
Setoguchi et al. (Wed,) conducted a observational in Heart failure. Calendar year (1996 to 2003) vs. 1996 was evaluated on Proportion of full adherence (proportion of days covered >80%). Full adherence to beta-blockers increased from 47% in 1996 to 57% in 2003, and to spironolactone from 31% to 42%, while adherence to angiotensin-system blockers remained unchanged at 54%.
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