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

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. Al...

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Detalles Bibliográficos
Autores principales: Uijl, Alicia, Vaartjes, Ilonca, Denaxas, S, Hemingway, Harry, Shah, Anoop, Cleland, J, Grobbee, Diederick, Hoes, Arno, Asselbergs, Folkert W, Koudstaal, Stefan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7929882/
https://www.ncbi.nlm.nih.gov/pubmed/33653753
http://dx.doi.org/10.1136/bmjopen-2020-043290
Descripción
Sumario: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.