Evidence based therapy and its association with workforce detachment following first hospitalization for heart failure

Rørth, R. et al. (2018) Evidence based therapy and its association with workforce detachment following first hospitalization for heart failure. JACC: Heart Failure, 6(1), pp. 41-48. (doi: 10.1016/j.jchf.2017.09.019) (PMID:29226811)

Abstract

Objectives: This study investigated the association between the use of evidence-based medicine (EBM) for heart failure (HF) and risk of workforce detachment. Background: The ability to work can be a marker of functional capacity and quality of life. Methods: We examined a nationwide cohort of patients in the workforce 1 year after first hospitalization for HF. EBM was defined as treatment with β-blockers and renin angiotensin system inhibitors. The fraction of target dose (0-1) for each drug was calculated. The sum of the fractions gave each patient a score between 0 and 2. Patients were stratified into 4 groups according to this score: group 4 score = 2 (target dose of both drugs); group 3 score <2 to >1; group 2 score ≤1 to >0.5; and group 1 score ≤0.5. The risk of subsequent workforce detachment was estimated in cause specific Cox regression models. Results: One year after first HF hospitalization, 10,185 patients were part of the workforce, and 7,561 (74%) were in treatment with at least 1 of the components of EBM. During a median follow-up of 727 days, 2,698 individuals (36%) became detached from the workforce. Patients receiving more EBM had a significantly lower risk of workforce detachment compared with those receiving less EBM (group 4 hazard ratio [HR]: 0.87; 95% confidence interval [CI]: 0.77 to 0.98; group 3 HR: 0.85; 95% CI: 0.77 to 0.94; and group 2 HR 0.92; 95% CI: 0.83 to 1.02), all compared to group 1. Conclusions: Patients in the workforce 1 year after first HF hospitalization and treated with target or near-target doses of EBM were associated with a significantly lower risk of subsequent workforce detachment.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Roerth, Dr Rasmus and Kristensen, Mr Soren Lund and Jhund, Professor Pardeep and Mogensen, Dr Ulrik and Petrie, Professor Mark and McMurray, Professor John and Kober, Professor Lars
• Authors: Rørth, R., Fosbøl, E. L., Mogensen, U. M., Kragholm, K., Jhund, P. S., Petrie, M. C., Schou, M., Gislason, G. H., McMurray, J. J.V., Torp-Pedersen, C., Køber, L., and Kristensen, S. L.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: JACC: Heart Failure
• Publisher: Elsevier
• ISSN: 2213-1779
• ISSN (Online): 2213-1787
• Published Online: 06 December 2017
• Copyright Holders: Copyright © 2018 The American College of Cardiology Foundation
• First Published: First published in JACC: Heart Failure 6(1):41-48
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher