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Long-term use of secondary prevention medications for heart failure in Western Australia: a protocol for a
Xiwen Qin1, Tiew-Hwa Katherine Teng1,2, Joseph Hung3
1School of Population Health, The University of Western Australia, Crawley, Western Australia, Australia.
Insights
This study examined heart failure medication dispensing and adherence in older Australians. Findings highlight suboptimal patterns and identify factors impacting patient outcomes, crucial for improving heart failure management.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Background:
- Heart failure (HF) is a chronic disease with significant morbidity and mortality.
- Evidence-based medications (EBMs) are vital for HF management but face dispensing and adherence challenges.
- Suboptimal medication use in HF impacts patient outcomes.
Purpose of the Study:
- To investigate dispensing patterns of EBMs for heart failure.
- To assess adherence and persistence to EBMs in HF patients.
- To identify factors influencing medication patterns and their impact on clinical outcomes.
Main Methods:
- Population-based cohort study using longitudinal data (2003-2008).
- Inclusion of individuals aged 65-84 hospitalized for HF in Western Australia.
- Utilized linked state and national data for medication dispensing, healthcare utilization, and mortality.
Main Results:
- Analysis of drug dispensing trends in heart failure patients.
- Estimation of drug adherence and persistence rates.
- Reporting the association between medication patterns and mortality/hospitalizations.
Conclusions:
- Understanding medication dispensing and adherence is critical for optimizing heart failure care.
- Identifying influencing factors can guide interventions to improve EBM use.
- This research provides insights into real-world medication management for heart failure.
Introduction:
Heart failure (HF) is a chronic, debilitating and progressive disease associated with high morbidity and mortality. Evidence-based medications (EBMs) are the cornerstone of management of patients with HF. In Australia, these EBMs are subsidised by the Commonwealth Government under the Pharmaceutical Benefits Scheme. Suboptimal dispensing and non-adherence to these EBMs have been observed in patients with HF. Our study will investigate trends in dispensing patterns, as well as adherence and persistence of EBMs for HF. We will also identify factors influencing these patterns and their impact on long-term clinical outcomes.
Methods And Analysis:
This whole population-based cohort study will use longitudinal data for people aged 65-84 years who were hospitalised for HF in Western Australia between 2003 and 2008. Linked state-wide and national data will provide patient-level information on medication dispensing, medical visits, hospitalisations and death. Drug dispensing trends will be described, drug adherence and persistence estimated and the association with all-cause/cardiovascular death and hospitalisations reported.
Ethics And Dissemination:
This project has received approvals from the Western Australian Department of Health Human Research Ethics Committee and the Western Australian Aboriginal Health Ethics Committee. Results will be published in relevant cardiology journals and presented at national and international conferences.
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