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Treatment of heart failure in Dutch general practice

Frans J M Bongers1, François G Schellevis, Carel Bakx

  • 1NIVEL (Netherlands Institute of Health Services Research), P,O, Box 1568 3800 BN Utrecht, The Netherlands. F.bongers@nivel.nl

BMC Family Practice
|July 11, 2006
PubMed

Insights

Heart failure medication prescription rates in general practice are significantly influenced by patient age and co-existing conditions, but not gender. Socioeconomic status has a minor impact on prescribing patterns for these cardiovascular drugs.

Area of Science:

  • Cardiology
  • General Practice
  • Pharmacoepidemiology

Background:

  • Investigating cardiovascular drug prescription patterns in heart failure (HF) patients within general practice.
  • Examining the influence of sociodemographic factors and comorbidities on HF medication use.

Purpose of the Study:

  • To determine the relationship between prescription rates of cardiovascular drugs (ACE-inhibitors/ARBs, beta-blockers, diuretics) and patient characteristics.
  • To analyze how age, gender, socioeconomic status, and comorbidities affect medication choices for heart failure patients.

Main Methods:

  • Utilized data from the second Dutch National Survey in General Practice (2001).
  • Included 96 general practices and 374,000 patients.
  • Analyzed electronic medical records for diagnoses and prescriptions, supplemented by a 76% response rate postal questionnaire for sociodemographic data.

Main Results:

  • Identified 2771 heart failure patients (7.1 per 1000), with a mean age of 77.7 years; 68% were ≥75 years old, and 55% were female.
  • Prescription rates: RAAS-I (50%), beta-blockers (32%), diuretics (86%). Combination therapy prescribed in 18%.
  • Prescription variations were primarily associated with patient age and the presence of concomitant diseases.

Conclusions:

  • Cardiovascular drug prescription for heart failure is largely driven by patient age and comorbidities.
  • Gender showed no significant influence, while socioeconomic status had a minor effect on prescription rates.
Abstract

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