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Patient Perceptions and Familiarity With Medical Therapy for Heart Failure.

Publication ,  Journal Article
Samsky, MD; Lin, L; Greene, SJ; Lippmann, SJ; Peterson, PN; Heidenreich, PA; Laskey, WK; Yancy, CW; Greiner, MA; Hardy, NC; Kavati, A; Park, S ...
Published in: JAMA Cardiol
March 1, 2020

IMPORTANCE: There are major gaps in use of guideline-directed medical therapy (GDMT) for patients with heart failure (HF). Patient-reported data outlining patient goals and preferences associated with GDMT are not available. OBJECTIVE: To survey patients with chronic HF to better understand their experiences and perceptions of living with HF, including their familiarity and concerns with important GDMT therapies. DESIGN, SETTING, AND PARTICIPANTS: Study participants were recruited from the GfK KnowledgePanel, a probability-sampled online panel representative of the US adult population. English-speaking adults who met the following criteria were eligible if they were (1) previously told by a physician that they had HF; (2) currently taking medications for HF; and (3) had no history of left ventricular assist device or cardiac transplant. Data were collected between October and November 2018. Analysis began in December 2018. MAIN OUTCOMES AND MEASURES: The survey included 4 primary domains: (1) relative importance of disease-related goals, (2) challenges associated with living with HF, (3) decision-making process associated with HF medication use, and (4) awareness and concerns about available HF medications. RESULTS: Of 30 707 KnowledgePanel members who received the initial survey, 15 091 (49.1%) completed the screening questions, 440 were eligible and began the survey, and 429 completed the survey. The median (interquartile range) age was 68 (60-75) years and most were white (320 [74.6%]), male (304 [70.9%]), and had at least a high school education (409 [95.3%]). Most survey responders reported familiarity with β-blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and diuretics. Overall, 107 (24.9%) reported familiarity with angiotensin receptor-neprilysin inhibitors or mineralocorticoid receptor antagonists. Overall, 136 patients (42.5%) reported have safety concerns regarding angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, and 133 (38.5%) regarding β-blockers, 35 (37.9%) regarding mineralocorticoid receptor antagonists, 38 (36.5%) regarding angiotensin receptor-neprilysin inhibitors, and 123 (37.2%) regarding diuretics. Between 27.7% (n = 26) and 38.5% (n = 136) reported concerns regarding the effectiveness of β-blockers, angiotensin receptor-neprilysin inhibitors, mineralocorticoid receptor antagonists, or diuretics, while 41% (n = 132) were concerned with the effectiveness of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers. CONCLUSIONS AND RELEVANCE: In this survey study, many patients were not familiar with GDMT for HF, with familiarity lowest for angiotensin receptor-neprilysin inhibitors and mineralocorticoid receptor antagonists. Among patients not familiar with these therapies, significant proportions questioned their effectiveness and/or safety. Enhanced patient education and shared decision-making support may be effective strategies to improve the uptake of GDMT for HF in US clinical practice.

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Published In

JAMA Cardiol

DOI

EISSN

2380-6591

Publication Date

March 1, 2020

Volume

5

Issue

3

Start / End Page

292 / 299

Location

United States

Related Subject Headings

  • Surveys and Questionnaires
  • Neprilysin
  • Mineralocorticoid Receptor Antagonists
  • Middle Aged
  • Male
  • Humans
  • Heart Failure
  • Health Knowledge, Attitudes, Practice
  • Goals
  • Focus Groups
 

Citation

APA
Chicago
ICMJE
MLA
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Samsky, M. D., Lin, L., Greene, S. J., Lippmann, S. J., Peterson, P. N., Heidenreich, P. A., … O’Brien, E. C. (2020). Patient Perceptions and Familiarity With Medical Therapy for Heart Failure. JAMA Cardiol, 5(3), 292–299. https://doi.org/10.1001/jamacardio.2019.4987
Samsky, Marc D., Li Lin, Stephen J. Greene, Steven J. Lippmann, Pamela N. Peterson, Paul A. Heidenreich, Warren K. Laskey, et al. “Patient Perceptions and Familiarity With Medical Therapy for Heart Failure.JAMA Cardiol 5, no. 3 (March 1, 2020): 292–99. https://doi.org/10.1001/jamacardio.2019.4987.
Samsky MD, Lin L, Greene SJ, Lippmann SJ, Peterson PN, Heidenreich PA, et al. Patient Perceptions and Familiarity With Medical Therapy for Heart Failure. JAMA Cardiol. 2020 Mar 1;5(3):292–9.
Samsky, Marc D., et al. “Patient Perceptions and Familiarity With Medical Therapy for Heart Failure.JAMA Cardiol, vol. 5, no. 3, Mar. 2020, pp. 292–99. Pubmed, doi:10.1001/jamacardio.2019.4987.
Samsky MD, Lin L, Greene SJ, Lippmann SJ, Peterson PN, Heidenreich PA, Laskey WK, Yancy CW, Greiner MA, Hardy NC, Kavati A, Park S, Mentz RJ, Fonarow GC, O’Brien EC. Patient Perceptions and Familiarity With Medical Therapy for Heart Failure. JAMA Cardiol. 2020 Mar 1;5(3):292–299.

Published In

JAMA Cardiol

DOI

EISSN

2380-6591

Publication Date

March 1, 2020

Volume

5

Issue

3

Start / End Page

292 / 299

Location

United States

Related Subject Headings

  • Surveys and Questionnaires
  • Neprilysin
  • Mineralocorticoid Receptor Antagonists
  • Middle Aged
  • Male
  • Humans
  • Heart Failure
  • Health Knowledge, Attitudes, Practice
  • Goals
  • Focus Groups