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Beta-blockers utilization in heart failure patients: Sub-analysis of a nation-wide population-based study in the
Milos Taborsky1, Renata Aiglova1, Marie Lazarova1
1Department of Internal Medicine I - Cardiology, University Hospital Olomouc, 775 20 Olomouc, Czech Republic.
Insights
Beta-blocker utilization for heart failure (HF) remained consistently high, around 82%, between 2012 and 2018. Metoprolol was the most prescribed beta-blocker, with increasing use of bisoprolol and nebivolol.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Background:
- Heart failure (HF) is a significant public health concern.
- Beta-blockers (BBs) are a cornerstone therapy for HF management.
- Understanding BB utilization patterns is crucial for optimizing HF care.
Purpose of the Study:
- To analyze trends in BB utilization among HF patients in the Czech Republic from 2012 to 2018.
- To identify the most frequently prescribed BBs for HF during the study period.
- To assess the translation of current HF treatment guidelines into clinical practice.
Main Methods:
- Retrospective, nation-wide observational analysis.
- Utilized data from the Czech National Registry of Reimbursed Health Services.
- Examined HF patient data and BB prescription patterns between 2012 and 2018.
Main Results:
- BBs were prescribed to approximately 81.8% to 83.3% of HF patients annually.
- In 2018, metoprolol (30.7%) and bisoprolol (28%) were the most prescribed BBs.
- Prescription rates shifted, with increasing use of bisoprolol and nebivolol, and decreasing use of carvedilol.
Conclusions:
- BB utilization in HF patients closely aligns with international standards.
- The findings suggest effective implementation of HF guidelines in routine clinical practice.
- Metoprolol remains the leading BB, but bisoprolol and nebivolol are gaining popularity.
Aims:
Sub-analysis of a retrospective nation-wide observational analysis of heart failure (HF) epidemiology reported to the Czech National Registry of Reimbursed Health Services between 2012 and 2018 aimed at beta-blockers (BBs) utilization.
Methods And Results:
The beta-blockers were generally used in 81.8% of all patients treated for HF in 2012 (n=52 140); 81.8% in 2013 (n=53 058); 83.1% in 2014 (n=56 221); 82.1% in 2015 (n=57 421); 83.3% in 2016 (n=59 187); 82.2% in 2017 (60 058) and in 81.4% in 2018 (n=60 966). In 2018, the majority of patients treated for HF were prescribed metoprolol (22 974; 30.7%) and bisoprolol (21 001; 28%). Carvedilol was prescribed in 7 331 patients treated for HF (9.8%), nebivolol in 5 392 HF patients. Despite its primary indication, betaxolol was used in 2 341 patients treated for HF (3.1%). All other beta-blockers were used in less than 1% of HF patients. In some of the mostly used BBs, their prescription in patients treated for HF changed in the last years (metoprolol 32.4% in 2012, 30.7% in 2018; bisoprolol 20.3% in 2012, 28% in 2018; carvedilol 18.3% in 2012, 9.8% in 2018; nebivolol 2.5% in 2012, 7.2% in 2018; betaxolol 4.2% in 2012, 3.1% in 2018).
Conclusion:
In an analysis of beta-blockers utilization in all patients treated for heart failure in the given year in the whole country, we have found only slightly lower amount of drug prescription in comparison with specific heart failure registries. This indicates a good translation of current standard of care into common clinical practice. Metoprolol remained the mostly prescribed drug. The prescription of bisoprolol and nebivolol has increased at the expense of carvedilol.
