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Beta-Blocker Therapy Early After Myocardial Infarction: A Comparison Between Medication at Hospital Discharge and Subsequent Pharmacy-Dispensed Medication
BACKGROUND: Beta-blocker (BB) therapy after myocardial infarction (MI) reduces all-cause mortality. OBJECTIVE: The aim of this study was to investigate BB dosing patterns and compliance following MI. METHODS: Using medical patient files and nationwide databases, we identified 100 patients who were d...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5042935/ https://www.ncbi.nlm.nih.gov/pubmed/27747827 http://dx.doi.org/10.1007/s40801-016-0079-0 |
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author | Pedersen, Susanne Bendesgaard Nielsen, Jens Cosedis Bøtker, Hans Erik Goldberger, Jeffrey J. |
author_facet | Pedersen, Susanne Bendesgaard Nielsen, Jens Cosedis Bøtker, Hans Erik Goldberger, Jeffrey J. |
author_sort | Pedersen, Susanne Bendesgaard |
collection | PubMed |
description | BACKGROUND: Beta-blocker (BB) therapy after myocardial infarction (MI) reduces all-cause mortality. OBJECTIVE: The aim of this study was to investigate BB dosing patterns and compliance following MI. METHODS: Using medical patient files and nationwide databases, we identified 100 patients who were discharged following MI in 2012 from Aarhus University Hospital, Denmark, and subsequently redeemed one or more BB prescriptions within 6 months. We obtained information about all BB medication prescribed at discharge and all BB prescriptions redeemed until 31 December 2013. Daily BB doses were computed as percentages of the target doses used in clinical trials documenting the efficacy of BBs after MI. Four dose groups were defined: ≤12.5, >12.5–25, >25–50, and >50 % of target dose. The proportion of patients in each dose group was ascertained at and following discharge, as was the proportion that changed dose group following discharge. RESULTS: The median study period was 400 days (interquartile range [IQR] 318–486 days). At discharge, 8 % of daily doses were >50 % of target dose while 80 % were ≤25 % of target dose. At first prescription redemption, 71.7 % of patients moved to a higher dose group (median dose change = 33.4 % [IQR 2.0–115.1]). Still, comparing final daily doses to discharge doses, 40.2 % did not change dose group (median dose change −5.7 % [IQR −18.0 to 4.2]). Only 31.5 % reached a final daily dose >50 % of target dose. CONCLUSIONS: Target dose BB treatment was infrequently achieved at discharge following MI. Despite dose up-titration early after discharge, most patients did not receive target dose BB treatment approximately 1 year following MI. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s40801-016-0079-0) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5042935 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-50429352016-10-14 Beta-Blocker Therapy Early After Myocardial Infarction: A Comparison Between Medication at Hospital Discharge and Subsequent Pharmacy-Dispensed Medication Pedersen, Susanne Bendesgaard Nielsen, Jens Cosedis Bøtker, Hans Erik Goldberger, Jeffrey J. Drugs Real World Outcomes Original Research Article BACKGROUND: Beta-blocker (BB) therapy after myocardial infarction (MI) reduces all-cause mortality. OBJECTIVE: The aim of this study was to investigate BB dosing patterns and compliance following MI. METHODS: Using medical patient files and nationwide databases, we identified 100 patients who were discharged following MI in 2012 from Aarhus University Hospital, Denmark, and subsequently redeemed one or more BB prescriptions within 6 months. We obtained information about all BB medication prescribed at discharge and all BB prescriptions redeemed until 31 December 2013. Daily BB doses were computed as percentages of the target doses used in clinical trials documenting the efficacy of BBs after MI. Four dose groups were defined: ≤12.5, >12.5–25, >25–50, and >50 % of target dose. The proportion of patients in each dose group was ascertained at and following discharge, as was the proportion that changed dose group following discharge. RESULTS: The median study period was 400 days (interquartile range [IQR] 318–486 days). At discharge, 8 % of daily doses were >50 % of target dose while 80 % were ≤25 % of target dose. At first prescription redemption, 71.7 % of patients moved to a higher dose group (median dose change = 33.4 % [IQR 2.0–115.1]). Still, comparing final daily doses to discharge doses, 40.2 % did not change dose group (median dose change −5.7 % [IQR −18.0 to 4.2]). Only 31.5 % reached a final daily dose >50 % of target dose. CONCLUSIONS: Target dose BB treatment was infrequently achieved at discharge following MI. Despite dose up-titration early after discharge, most patients did not receive target dose BB treatment approximately 1 year following MI. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s40801-016-0079-0) contains supplementary material, which is available to authorized users. Springer International Publishing 2016-06-16 /pmc/articles/PMC5042935/ /pubmed/27747827 http://dx.doi.org/10.1007/s40801-016-0079-0 Text en © The Author(s) 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Original Research Article Pedersen, Susanne Bendesgaard Nielsen, Jens Cosedis Bøtker, Hans Erik Goldberger, Jeffrey J. Beta-Blocker Therapy Early After Myocardial Infarction: A Comparison Between Medication at Hospital Discharge and Subsequent Pharmacy-Dispensed Medication |
title | Beta-Blocker Therapy Early After Myocardial Infarction: A Comparison Between Medication at Hospital Discharge and Subsequent Pharmacy-Dispensed Medication |
title_full | Beta-Blocker Therapy Early After Myocardial Infarction: A Comparison Between Medication at Hospital Discharge and Subsequent Pharmacy-Dispensed Medication |
title_fullStr | Beta-Blocker Therapy Early After Myocardial Infarction: A Comparison Between Medication at Hospital Discharge and Subsequent Pharmacy-Dispensed Medication |
title_full_unstemmed | Beta-Blocker Therapy Early After Myocardial Infarction: A Comparison Between Medication at Hospital Discharge and Subsequent Pharmacy-Dispensed Medication |
title_short | Beta-Blocker Therapy Early After Myocardial Infarction: A Comparison Between Medication at Hospital Discharge and Subsequent Pharmacy-Dispensed Medication |
title_sort | beta-blocker therapy early after myocardial infarction: a comparison between medication at hospital discharge and subsequent pharmacy-dispensed medication |
topic | Original Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5042935/ https://www.ncbi.nlm.nih.gov/pubmed/27747827 http://dx.doi.org/10.1007/s40801-016-0079-0 |
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