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Multifaceted intervention to promote beta-blocker use in heart failure.

Publication ,  Journal Article
LaPointe, NMA; DeLong, ER; Chen, A; Hammill, BG; Muhlbaier, LH; Califf, RM; Kramer, JM
Published in: Am Heart J
May 2006

BACKGROUND: Despite a survival benefit and guideline recommendation for beta-blockers in left ventricular systolic dysfunction, beta-blockers are underused in clinical practice. METHODS: Medical practices with > or = 15 patients with heart failure (HF) in the Duke Databank for Cardiovascular Disease (DDCD) were identified for a prospective, randomized study using a multifaceted intervention to improve beta-blocker use. Intervention practices received provider education, patient education materials, feedback on beta-blocker use of their patients with HF, and access to telephone consultation with an HF expert. The primary outcome was a comparison between intervention and control practices of the proportion of patients with HF self-reporting beta-blocker use on their first routine DDCD follow-up in the postintervention year. A random effects model was used for the analysis. RESULTS: Post intervention, 2631 patients (1701 in 23 intervention practices and 930 in 22 control practices) completed DDCD follow-up. No significant difference in the proportion of patients with HF reporting beta-blocker use was found in the intervention versus control groups (OR 1.16, 95% CI 0.94-1.43, P = .2), although more patients in the intervention group started a beta-blocker than stopped a beta-blocker during the study period (P = .02). CONCLUSIONS: This multifaceted intervention did not significantly increase the mean proportion of patients taking beta-blockers within practices exposed to the intervention, although favorable trends were observed. Further studies are needed to identify and evaluate strategies for translating evidence into clinical practice to reduce the global health burden associated with HF.

Duke Scholars

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

May 2006

Volume

151

Issue

5

Start / End Page

992 / 998

Location

United States

Related Subject Headings

  • Remote Consultation
  • Practice Patterns, Physicians'
  • Patient Education as Topic
  • Knowledge of Results, Psychological
  • Humans
  • Heart Failure
  • Education, Medical, Continuing
  • Drug Prescriptions
  • Cardiovascular System & Hematology
  • Cardiac Output, Low
 

Citation

APA
Chicago
ICMJE
MLA
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LaPointe, N. M. A., DeLong, E. R., Chen, A., Hammill, B. G., Muhlbaier, L. H., Califf, R. M., & Kramer, J. M. (2006). Multifaceted intervention to promote beta-blocker use in heart failure. Am Heart J, 151(5), 992–998. https://doi.org/10.1016/j.ahj.2005.06.038
LaPointe, Nancy M Allen, Elizabeth R. DeLong, Anita Chen, Bradley G. Hammill, Lawrence H. Muhlbaier, Robert M. Califf, and Judith M. Kramer. “Multifaceted intervention to promote beta-blocker use in heart failure.Am Heart J 151, no. 5 (May 2006): 992–98. https://doi.org/10.1016/j.ahj.2005.06.038.
LaPointe NMA, DeLong ER, Chen A, Hammill BG, Muhlbaier LH, Califf RM, et al. Multifaceted intervention to promote beta-blocker use in heart failure. Am Heart J. 2006 May;151(5):992–8.
LaPointe, Nancy M. Allen, et al. “Multifaceted intervention to promote beta-blocker use in heart failure.Am Heart J, vol. 151, no. 5, May 2006, pp. 992–98. Pubmed, doi:10.1016/j.ahj.2005.06.038.
LaPointe NMA, DeLong ER, Chen A, Hammill BG, Muhlbaier LH, Califf RM, Kramer JM. Multifaceted intervention to promote beta-blocker use in heart failure. Am Heart J. 2006 May;151(5):992–998.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

May 2006

Volume

151

Issue

5

Start / End Page

992 / 998

Location

United States

Related Subject Headings

  • Remote Consultation
  • Practice Patterns, Physicians'
  • Patient Education as Topic
  • Knowledge of Results, Psychological
  • Humans
  • Heart Failure
  • Education, Medical, Continuing
  • Drug Prescriptions
  • Cardiovascular System & Hematology
  • Cardiac Output, Low