Hospital Variation in Adherence Rates to Secondary Prevention Medications and the Implications on Quality
Main finding · MACEResult — go to the resultAdjusted hazard ratio 0.88 95% CI 0.80–0.96Authors' conclusion
Use of secondary prevention medications after discharge varies significantly among US hospitals and is inversely associated with 2-year outcomes.
Study context
- Population
- Medicare patients discharged after acute myocardial infarction (MI) from US hospitals, 2007–2010
- Participants
- 19,704 patients347 US hospitals
- Exposure
- Hospitals with highest vs lowest quartile of 90-day composite medication adherence
- Outcome
- MACE
- Follow-up
- 2 years
Methodological detailsregistry-based (ACTION Registry-GWTG), linked Medicare Part D data
- Registry-based (ACTION Registry-GWTG)
- Linked Medicare Part D data
Main finding
As reported in the abstract
Adjusted hazard ratio
0.88
95% CI 0.80–0.96
By group
Highest adherencevs Lowest quartile
adjusted HR 0.88 (95% CI 0.80–0.96)
Observational data: associations, not effects.
Further findings
90-day adherence to discharge medications, overall (PDC >80%) · 90 days after MI
- β-blockers
- 68%
- Statins
- 63%
- ACEi/ARB
- 64%
- Thienopyridines
- 72%
Hospital variation in 90-day adherence (PDC >80%) · up to 90 days
- β-blockers
- 59% to 75%
- Statins
- 55% to 69%
- Thienopyridines
- 64% to 77%
- ACEi/ARB
- 57% to 69%
- Adherence varied significantly among hospitals
Death or readmission
- High-adherence hospitals had lower adjusted rates of death or readmission
- HR 0.90 (0.85-0.96) (95% CI)
Mortality
- No difference in mortality after adjustment
- Adjusted
Original publication
Hospital Variation in Adherence Rates to Secondary Prevention Medications and the Implications on Quality. Circulation. Published 31 January 2018. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →