Abstract 3994: Assessment of Heart Failure Therapy Utilization Between Publication of the 2001 and 2005 ACC/AHA Heart Failure Guidelines in a Managed Care Setting
Background: The ACC/AHA have recently (Aug 2005) updated the 2001 guidelines for the diagnosis and management of chronic heart failure (HF) in adults. This analysis describes the use of evidence-based therapies recommended in the outpatient treatment of HF in the time period between the guideline publications.
Methods: This was a retrospective, incidence based HF cohort analysis within a large US managed care database. Eligible patients had ≥ 2 office visit or hospital claims with an ICD-9 code for systolic dysfunction HF within a 90 day period between 1/1/01 to 11/30/04, did not have ≥ 2 HF ICD-9 codes within 90 days in the prior 12 months, and had health plan eligibility 12 months pre and post HF diagnosis. HF therapies (defined as ≥ 2 prescription claims) were evaluated over the entire study period and by calendar year to evaluate prescribing trends over time for the 3 and 12 month periods following HF diagnosis. The chi-square test was used to evaluate differences in percentages of HF patients receiving specific therapies.
Results: A total of 15,099 HF patients (mean age = 67±15) were identified. Between 2001 and 2004, an increase in utilization of beta blockers, aldosterone inhibitors and angiotensin receptor blockers [ARBs] was observed, and decreased utilization of ACE inhibitors and digitalis was seen. (all p<0.05 - see table⇓) Beta blockers and diuretics were the only individual medications used in greater than 50% of patients.