Heart failure & cardiomyopathies
National Trends in Hospital Performance in Guideline-Recommended Pharmacologic Treatment for Heart Failure at Discharge
Main finding · Receipt of all recommended HF medicationsResult — go to the resultOdds ratio 1.54 95% CI 1.44–1.65Authors' conclusion
Forty-two percent of patients did not receive all recommended HF medications at discharge, particularly women, minority patients, and those receiving care at urban hospitals. Rates of use increased over time, with variation in performance across hospitals.
Study context
- Population
- Patients discharged with heart failure (HF) from US Veterans Affairs (VA) hospitals, 2013–2019
- Participants
- 55,560 patients122 hospitals
- Outcome
- Receipt of all guideline-recommended HF medications for which eligible (evidence-based beta-blockers; ACEi, ARB or ARNI; MRA; OAC)
- Follow-up
- Discharge
Methodological detailsnational, 122 VA hospitals
- National
- 122 VA hospitals
Main finding
Receipt of all recommended HF medications
Odds ratio
1.54
95% CI 1.44–1.65
2019vs 2013
OR 1.54 (95% CI 1.44–1.65)
As reported in the abstract
- Received all recommended HF medications
- 32,304 (58.1%)
- Median hospital performance (Q1-Q3: 53.2%-66.2%)
- 59.1%
- Median hospital performance 2013 (Q1-Q3: 50.0%-62.0%)
- 56.4%
- Median hospital performance 2019 (Q1-Q3: 56.3%-73.5%)
- 65.7%
Observational data: associations, not effects.
Further findings
| Outcome | aOR (95% CI) | |
|---|---|---|
| Receipt of all recommended HF medications, by sex, race/ethnicity and hospital locationWomenvs Men | 0.84 (0.74–0.96) | |
| Receipt of all recommended HF medications, by sex, race/ethnicity and hospital locationNon-Hispanic Blackvs Non-Hispanic White | 0.83 (0.79–0.87) | |
| 0.512Adjusted odds ratio (log scale) |
Receipt of all recommended HF medications, by sex, race/ethnicity and hospital location
| aOR (95% CI) | ||
|---|---|---|
| Urban hospital locationLower likelihood of medication receipt | 0.73 (0.59–0.92) | |
| 0.512Adjusted odds ratio (log scale) |
Original publication
National Trends in Hospital Performance in Guideline-Recommended Pharmacologic Treatment for Heart Failure at Discharge. JACC Heart Fail. Published 3 April 2024. doi:10.
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