Heart failure & cardiomyopathiesCohort study
Initiation, Adherence, and Persistence to Guideline-Directed Medical Therapy After Heart Failure Hospitalization
- cohort study
Authors' conclusion
This cohort study found that following HF hospitalization, most new guideline-directed medical therapy prescriptions went unfilled. Moreover, most newly initiated prescriptions did not persist at 6 months, suggesting a need to develop interventions to support patients’ medication use beyond the initial prescription at discharge.
Study context
- Population
- Patients in a regional US health system discharged home after an heart failure (HF) hospitalization between July 1, 2017, and March 30, 2023patients with HF hospitalizations
- Participants
- 6,111 patients
Main finding
As reported in the abstract
Prescribed at least 1 new HF medication at discharge
51%
Observational data: associations, not effects.
Further findings
Medication use at admission and at discharge
- β-blockers at admission
- 58.1% (3549)
- Renin-angiotensin system inhibitors (RASis) at admission
- 41.4% (2530)
- Mineralocorticoid receptor antagonists (MRAs) at admission
- 16.3% (997)
- SGLT2is at admission
- 4.9% (299)
- β-blockers at discharge
- 73.3% (4481)
- RASis at discharge
- 52.9% (3232)
- MRAs at discharge
- 28.5% (1740)
- SGLT2is at discharge
- 9.0% (548)
Primary nonadherence (discharge prescriptions not filled), of new prescriptions
- β-blockers
- 51% (972 of 1904)
- RASis
- 48% (659 of 1361)
- MRAs
- 39% (482 of 1225)
- SGLT2is
- 35% (134 of 383)
Initiation of new discharge prescriptions (of 4873) · 7 and 90 days postdischarge
- Initiated within 7 days of discharge
- 54% (2626)
- Delayed initiation, between 7 and 90 days postdischarge
- 20% (954)
Persistence, of medications used at discharge · 6 months
- β-blockers
- 70% (3127 of 4481)
- RASis
- 60% (1952 of 3232)
- MRAs
- 55% (961 of 1740)
- SGLT2is
- 56% (306 of 548)
Adherence and persistence to all HF medications used at discharge · 6 months
- Adherent
- 42% (2188 of 5183)
- Persistent
- 51% (2620 of 5183)
Original publication
Summarised from the published abstract; every number is checked against it