Use of guideline-recommended therapies for heart failure in the Medicare population.


Journal Article

Most information about the use of guideline-recommended therapies for heart failure reflects what occurred at discharge after an inpatient stay.Using a nationally representative, community-dwelling sample of elderly Medicare beneficiaries, we examined how the use of angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and beta-blockers has changed and factors associated with their use.Using data from the Medicare Current Beneficiary Survey cost and use files matched with Medicare claims data, we identified beneficiaries for whom a diagnosis of heart failure was reported between January 1, 2000, and December 31, 2004. Data on medications prescribed during the year of cohort entry were based on patient self-report. We used multivariable logistic regression to explore relationships between the use of ACE inhibitors/ARBs and beta-blockers and patient demographic characteristics.From 2000 through 2004, the use of ARBs increased from 12% to 19%, and the use of beta-blockers increased from 30% to 41%. The use of ACE inhibitors remained constant at 45%. Beneficiaries who reported having prescription drug insurance coverage were 32% more likely than other beneficiaries to have filled a prescription for an ACE inhibitor or ARB and 26% more likely to have filled a prescription for a beta-blocker.Although the use of guideline-recommended therapies for heart failure has increased, it remains suboptimal.

Full Text

Duke Authors

Cited Authors

  • DiMartino, LD; Shea, AM; Hernandez, AF; Curtis, LH

Published Date

  • July 2010

Published In

Volume / Issue

  • 33 / 7

Start / End Page

  • 400 - 405

PubMed ID

  • 20641116

Pubmed Central ID

  • 20641116

Electronic International Standard Serial Number (EISSN)

  • 1932-8737

International Standard Serial Number (ISSN)

  • 0160-9289

Digital Object Identifier (DOI)

  • 10.1002/clc.20760


  • eng