Heart failure & cardiomyopathiesCohort study
National Trends in Hospital Performance in Guideline-Recommended Pharmacologic Treatment for Heart Failure at Discharge
- Retrospective cohort study
- national
- 122 Veterans Affairs (VA) hospitals
Authors' 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 VA hospitals, 2013–2019
- Participants
- 55,560 patients · 122 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
Main finding
Receipt of all recommended HF medications
Odds ratio
1.54
95% CI 1.44–1.65
2019 vs 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 location — Women vs Men | 0.84 (0.74–0.96) | |
| Receipt of all recommended HF medications, by sex, race/ethnicity and hospital location — Non-Hispanic Black vs 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
| Comparison | aOR (95% CI) | |
|---|---|---|
| Urban hospital location · lower 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:10.1016/j.jchf.2024.02.014
Summarised from the published abstract; every number is checked against it