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

Uijl, A., Vaartjes, I., Denaxas, S., Hemingway, H., Shah, A. D., Cleland, J. , Grobbee, D. E., Hoes, A. W., Asselbergs, F. W. and Koudstaal, S. (2021) Temporal trends in heart failure medication prescription in a population-based cohort study. BMJ Open, 11(3), e043290. (doi: 10.1136/bmjopen-2020-043290) (PMID:33653753) (PMCID:PMC7929882)

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Abstract

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.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Cleland, Professor John
Authors: Uijl, A., Vaartjes, I., Denaxas, S., Hemingway, H., Shah, A. D., Cleland, J., Grobbee, D. E., Hoes, A. W., Asselbergs, F. W., and Koudstaal, S.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:BMJ Open
Publisher:BMJ Publishing Group
ISSN:2044-6055
ISSN (Online):2044-6055
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in BMJ Open 11(3):e043290
Publisher Policy:Reproduced under a Creative Commons licence

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