Abstract:
BACKGROUND:Despite a survival benefit and guideline recommendation for beta-blockers in left ventricular systolic dysfunction, beta-blockers are underused in clinical practice. METHODS:Medical practices with > or = 15 patients with heart failure (HF) in the Duke Databank for Cardiovascular Disease (DDCD) were identified for a prospective, randomized study using a multifaceted intervention to improve beta-blocker use. Intervention practices received provider education, patient education materials, feedback on beta-blocker use of their patients with HF, and access to telephone consultation with an HF expert. The primary outcome was a comparison between intervention and control practices of the proportion of patients with HF self-reporting beta-blocker use on their first routine DDCD follow-up in the postintervention year. A random effects model was used for the analysis. RESULTS:Post intervention, 2631 patients (1701 in 23 intervention practices and 930 in 22 control practices) completed DDCD follow-up. No significant difference in the proportion of patients with HF reporting beta-blocker use was found in the intervention versus control groups (OR 1.16, 95% CI 0.94-1.43, P = .2), although more patients in the intervention group started a beta-blocker than stopped a beta-blocker during the study period (P = .02). CONCLUSIONS:This multifaceted intervention did not significantly increase the mean proportion of patients taking beta-blockers within practices exposed to the intervention, although favorable trends were observed. Further studies are needed to identify and evaluate strategies for translating evidence into clinical practice to reduce the global health burden associated with HF.
journal_name
Am Heart Jjournal_title
American heart journalauthors
LaPointe NM,DeLong ER,Chen A,Hammill BG,Muhlbaier LH,Califf RM,Kramer JMdoi
10.1016/j.ahj.2005.06.038subject
Has Abstractpub_date
2006-05-01 00:00:00pages
992-8issue
5eissn
0002-8703issn
1097-6744pii
S0002-8703(05)00655-1journal_volume
151pub_type
杂志文章,随机对照试验abstract::The antihypertensive effects of the renin inhibitor enalkiren were compared with those of the angiotensin-converting enzyme inhibitor enalaprilat in 17 hypertensive patients (14 white, 3 black; mean age 57 years), whose renin systems had been stimulated by diuretic pretreatment. Patients were studied on 3 separate in-...
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journal_title:American heart journal
pub_type: 杂志文章
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journal_title:American heart journal
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journal_title:American heart journal
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journal_title:American heart journal
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更新日期:1998-10-01 00:00:00
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journal_title:American heart journal
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journal_title:American heart journal
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journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:American heart journal
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更新日期:2003-05-01 00:00:00
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更新日期:2012-02-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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pub_type: 杂志文章
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更新日期:2015-03-01 00:00:00
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更新日期:1994-06-01 00:00:00
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更新日期:1987-09-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2019-02-01 00:00:00
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pub_type: 杂志文章
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更新日期:2012-11-01 00:00:00
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