Abstract 3110: Adherence to Beta-blockers and ACE Inhibitors/Angiotensin Receptor Blockers in the First Year after Diagnosis of Heart Failure: 10 Year Observational Trends
Introduction: As prescriptions for evidence based medications in patients with heart failure (HF) have increased over the past 10 years, we aimed to determine if adherence to HF medications has also increased over this time.
Methods: A retrospective cohort was created using administrative databases from the province of Saskatchewan, Canada. Subjects discharged alive from their first hospitalization for HF between 1994 and 2003 were eligible for study. Those filling a prescription for a beta blocker (BB), ACE inhibitor (ACEI), or angiotensin receptor blocker (ARB) within six months after discharge were selected. The proportion of subjects with optimal 1-year adherence (≥ 80%) was determined and divided according to the year of entry into the study.
Results: Of 8,805 eligible patients, 67% of BB users (941/1414) and 74% of ACEI/ARB users (4441/5991) exhibited 1-year adherence ≥ 80%. When grouped by year of initial HF hospitalization, the proportion of patients with optimal 1-year adherence improved from 54% to 75% with BB and from 67% to 80% with ACEI/ARBs between 1994/95 and 2002/03 [Figure⇓]. Mean 1-year adherence improved from 71% to 83% and 80% to 88% for BB and ACEI/ARBs, respectively. After covariate adjustment using multivariate logistic regression, year of initial HF hospitalization remained independently associated with optimal 1-year adherence. Subjects discharged in 2003 were significantly more likely to exhibit optimal adherence to a BB (OR 2.04; 95% CI 1.21–3.44) or an ACEI/ARB (OR 1.65; 95% CI 1.30–2.08) than those prescribed therapy in 1994/95.
Conclusion: One year adherence to BB and ACEI/ARB is improving over time in patients newly diagnosed with HF.