Objective: Determine proportion of heart failure (HF) patients who receive Angiotensin Converting Enzyme Inhibitors (ACEI) as recommended by American Heart Association and Agency for Health Care Policy and Research. Measures analyzed include: ACEI use; use at recommended dosage; and continuation of use.
Method: Health care claims data were used to identify patients with a principle or secondary diagnosis for HF (either inpatient or outpatient) during 1998. Study members were non-medicare, aged 21-65 with continuous membership in an employer-based health insurance plan that included pharmacy, professional and facility coverage. Patients' pharmacy claims were analyzed for 9 months to determine the percent of the patients with: 1) a claim for ACEI at the time of identification of HF; 2) any claim for ACEI at the recommended dosage; and 3) to determine the pattern of use.
Results: The rate of ACEI use was 61.7% (n=2,808); the rate for those with an inpatient stay for HF was significantly higher rate than those without an inpatient stay (65.3% versus 55.2%; p<0.05). Proportion of members having a pharmacy claim for ACEI at recommended dosage was 54.3%. Forty percent of patients had continuous use, 21.9% had intermittent or discontinuous use and 38.3% had no use of ACEI.
Conclusion: ACEI rates have improved in recent years, however, this study demonstrates that HF patients often discontinue use. Study findings will be shared with physicians, medical societies and community coalitions. In conjunction with ongoing collaboration with hospitals, facility-specific rates will be provided for follow-up and ongoing quality improvement.
Learning Objectives: As a result of reviewing this study, participants will be aware that not all heart failure patients continue ACEI therapy and not all heart failure patients are receiving the recommended dosages
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.