Objective: This study assessed the continued use of beta-blockers after hospital discharge for patients surviving an acute myocardial infarction (AMI). Predictors of beta-blocker use at discharge and for nine months after discharge were examined.
Methods: Patients discharged from an inpatient facility with a diagnosis of AMI in 1998 who had pharmacy benefits were selected from commercial health insurance claims data (n=1128). The rates of beta-blocker use by different demographic groups within this population were calculated using HEDIS 1999 specifications. Patient variables were examined for correlation with one another, and odds ratios for beta-blocker use predictors were calculated. Patients were followed for nine months after discharge to determine patterns of beta-blocker use during this period.
Results: Statistical analysis revealed differences in beta-blocker use between different demographic groups. Variation in use was attributed to member age, gender, region of residence, and purchaser. Although beta-blocker use at discharge (86%) was less than optimal, the rate exceeded the NCQA 1998 national and 3 year public reporter rates (80% and 85%, respectively). However, only half of all AMI patients continuously used beta-blockers, 18 percent used them intermittently, and 19 percent discontinued their use during the nine months following discharge.
Conclusion: Use of beta-blockers after discharge from an AMI hospitalization is approaching optimal levels but patients need to remain on the drug to derive continued benefit. Patients at risk for discontinuing beta-blocker treatment should be the focus of more intense study, including the evaluation of interventions aimed at increasing long-term compliance with clinical guidelines.
Learning Objectives: As a result of reviewing this study, participants will be aware that some AMI patients do not continue beta-blocker therapy and interventions should be aimed at improving compliance with clinical guidelines
Keywords: Heart Disease, Prescription Drug Use Patterns
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.