Details
| Translated title of the contribution | Impact of guideline adherence on mortality in treatment of left heart failure |
|---|---|
| Original language | German |
| Pages (from-to) | 614-624 |
| Number of pages | 11 |
| Journal | HERZ |
| Volume | 41 |
| Issue number | 7 |
| Early online date | 16 Feb 2016 |
| Publication status | Published - Nov 2016 |
Abstract
Background: The German national guidelines on chronic heart failure provide treatment recommendations to physicians and reflect the current level of evidence; however, it is questionable to what extent these recommendations are applied in the routine practice and what the effect of guideline adherence on mortality is. Methods: In this study the claims data of a major German health insurance fund collected over a period of 4 years were analyzed. Using binary logistic regression and Cox regression analyses the influence of drug prescriptions, diagnostic measures, influenza vaccination, the New York Heart Association (NYHA) status, the age and gender on mortality were examined. Results: The study population consisted of 85,465 heart failure patients. Approximately 60 % of the drugs were prescribed according to the guidelines. There was a positive correlation between a higher NYHA status and mortality with an odds ratio (OR) of 3.264. Especially pharmacotherapy with angiotensin-converting enzyme (ACE) inhibitors and beta blockers according to the guidelines was associated with a lower mortality rate (OR 0.448 resp. 0.444). Also patients diagnosed using echocardiography at regular intervals showed a lower risk of dying (OR 0.314). Conclusion: The results of this large sample could confirm the results of clinical trials that a therapy according to the guidelines has a significant impact on mortality. By analyzing the claims data evidence was found that in the treatment of heart failure patients the medical results could be improved by adherence to guideline recommendations.
ASJC Scopus subject areas
- Medicine(all)
- Cardiology and Cardiovascular Medicine
Sustainable Development Goals
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In: HERZ, Vol. 41, No. 7, 11.2016, p. 614-624.
Research output: Contribution to journal › Article › Research › peer review
}
TY - JOUR
T1 - Auswirkung einer leitliniengerechten Behandlung auf die Mortalität bei Linksherzinsuffizienz
AU - Neubauer, S.
AU - Schilling, T.
AU - Zeidler, J.
AU - Lange, A.
AU - Engel, S.
AU - Linder, R.
AU - Verheyen, F.
AU - von der Schulenburg, J. M.Graf
AU - Haverich, A.
PY - 2016/11
Y1 - 2016/11
N2 - Background: The German national guidelines on chronic heart failure provide treatment recommendations to physicians and reflect the current level of evidence; however, it is questionable to what extent these recommendations are applied in the routine practice and what the effect of guideline adherence on mortality is. Methods: In this study the claims data of a major German health insurance fund collected over a period of 4 years were analyzed. Using binary logistic regression and Cox regression analyses the influence of drug prescriptions, diagnostic measures, influenza vaccination, the New York Heart Association (NYHA) status, the age and gender on mortality were examined. Results: The study population consisted of 85,465 heart failure patients. Approximately 60 % of the drugs were prescribed according to the guidelines. There was a positive correlation between a higher NYHA status and mortality with an odds ratio (OR) of 3.264. Especially pharmacotherapy with angiotensin-converting enzyme (ACE) inhibitors and beta blockers according to the guidelines was associated with a lower mortality rate (OR 0.448 resp. 0.444). Also patients diagnosed using echocardiography at regular intervals showed a lower risk of dying (OR 0.314). Conclusion: The results of this large sample could confirm the results of clinical trials that a therapy according to the guidelines has a significant impact on mortality. By analyzing the claims data evidence was found that in the treatment of heart failure patients the medical results could be improved by adherence to guideline recommendations.
AB - Background: The German national guidelines on chronic heart failure provide treatment recommendations to physicians and reflect the current level of evidence; however, it is questionable to what extent these recommendations are applied in the routine practice and what the effect of guideline adherence on mortality is. Methods: In this study the claims data of a major German health insurance fund collected over a period of 4 years were analyzed. Using binary logistic regression and Cox regression analyses the influence of drug prescriptions, diagnostic measures, influenza vaccination, the New York Heart Association (NYHA) status, the age and gender on mortality were examined. Results: The study population consisted of 85,465 heart failure patients. Approximately 60 % of the drugs were prescribed according to the guidelines. There was a positive correlation between a higher NYHA status and mortality with an odds ratio (OR) of 3.264. Especially pharmacotherapy with angiotensin-converting enzyme (ACE) inhibitors and beta blockers according to the guidelines was associated with a lower mortality rate (OR 0.448 resp. 0.444). Also patients diagnosed using echocardiography at regular intervals showed a lower risk of dying (OR 0.314). Conclusion: The results of this large sample could confirm the results of clinical trials that a therapy according to the guidelines has a significant impact on mortality. By analyzing the claims data evidence was found that in the treatment of heart failure patients the medical results could be improved by adherence to guideline recommendations.
KW - Claims data
KW - Guideline adherence
KW - Heart failure
KW - Mortality
KW - Pharmacotherapy
UR - http://www.scopus.com/inward/record.url?scp=84958751498&partnerID=8YFLogxK
U2 - 10.1007/s00059-016-4401-0
DO - 10.1007/s00059-016-4401-0
M3 - Artikel
C2 - 26883900
AN - SCOPUS:84958751498
VL - 41
SP - 614
EP - 624
JO - HERZ
JF - HERZ
SN - 0340-9937
IS - 7
ER -