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Medication dosing in outpatients with heart failure after implementation of a practice-based performance improvement intervention: findings from IMPROVE HF.

Publication ,  Journal Article
Gheorghiade, M; Albert, NM; Curtis, AB; Thomas Heywood, J; McBride, ML; Inge, PJ; Mehra, MR; O'Connor, CM; Reynolds, D; Walsh, MN; Yancy, CW ...
Published in: Congest Heart Fail
2012

Eligible outpatients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF) frequently do not receive target doses of HF medications. The Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF) evaluated the effect of a practice-based performance improvement intervention on treatment of outpatients with LVEF ≤35%. Specific agent and dose were collected at baseline and 24 months for angiotensin-converting enzyme (ACE) inhibitors/angiotensin receptor blockers (ARBs), β-blockers, and aldosterone antagonists. Changes in dosing over time were analyzed for each medication class. Data were available for 7605 patients. At baseline, target dose treatment rates were 36.1%, 20.5%, and 74.4%, respectively. Absolute and relative improvements of 9.8% and 47.7% ( P<.001) were achieved for β-blocker dosing at 24 months. The IMPROVE HF intervention was associated with significantly increased treatment of eligible patients with target doses of β-blockers but not ACE inhibitors/ARBs or aldosterone antagonists. Additional research to determine barriers to use of target doses of HF medications may be necessary.

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Published In

Congest Heart Fail

DOI

EISSN

1751-7133

Publication Date

2012

Volume

18

Issue

1

Start / End Page

9 / 17

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Left
  • United States
  • Registries
  • Quality Assurance, Health Care
  • Prospective Studies
  • Practice Patterns, Physicians'
  • Outpatients
  • Mineralocorticoid Receptor Antagonists
  • Middle Aged
  • Male
 

Citation

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Gheorghiade, M., Albert, N. M., Curtis, A. B., Thomas Heywood, J., McBride, M. L., Inge, P. J., … Fonarow, G. C. (2012). Medication dosing in outpatients with heart failure after implementation of a practice-based performance improvement intervention: findings from IMPROVE HF. Congest Heart Fail, 18(1), 9–17. https://doi.org/10.1111/j.1751-7133.2011.00250.x
Gheorghiade, Mihai, Nancy M. Albert, Anne B. Curtis, J. Thomas Heywood, Mark L. McBride, Patches Johnson Inge, Mandeep R. Mehra, et al. “Medication dosing in outpatients with heart failure after implementation of a practice-based performance improvement intervention: findings from IMPROVE HF.Congest Heart Fail 18, no. 1 (2012): 9–17. https://doi.org/10.1111/j.1751-7133.2011.00250.x.
Gheorghiade M, Albert NM, Curtis AB, Thomas Heywood J, McBride ML, Inge PJ, et al. Medication dosing in outpatients with heart failure after implementation of a practice-based performance improvement intervention: findings from IMPROVE HF. Congest Heart Fail. 2012;18(1):9–17.
Gheorghiade, Mihai, et al. “Medication dosing in outpatients with heart failure after implementation of a practice-based performance improvement intervention: findings from IMPROVE HF.Congest Heart Fail, vol. 18, no. 1, 2012, pp. 9–17. Pubmed, doi:10.1111/j.1751-7133.2011.00250.x.
Gheorghiade M, Albert NM, Curtis AB, Thomas Heywood J, McBride ML, Inge PJ, Mehra MR, O’Connor CM, Reynolds D, Walsh MN, Yancy CW, Fonarow GC. Medication dosing in outpatients with heart failure after implementation of a practice-based performance improvement intervention: findings from IMPROVE HF. Congest Heart Fail. 2012;18(1):9–17.
Journal cover image

Published In

Congest Heart Fail

DOI

EISSN

1751-7133

Publication Date

2012

Volume

18

Issue

1

Start / End Page

9 / 17

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Left
  • United States
  • Registries
  • Quality Assurance, Health Care
  • Prospective Studies
  • Practice Patterns, Physicians'
  • Outpatients
  • Mineralocorticoid Receptor Antagonists
  • Middle Aged
  • Male