Changes in rates of beta-blocker use in community hospital patients with acute myocardial infarction.
OBJECTIVE
To examine changes in the rate of beta-blocker (BB) use at admission, in hospital, and at discharge between 1994 and 1995 (MICH I) and 1997 (MICH II) in patients with acute myocardial infarction (AMI).


METHODS
Comparison of two prospectively enrolled cohorts.


METHODS
Five mid-Michigan community hospitals.


METHODS
We studied 287 MICH I patients and 121 MICH II patients with AMI who had no contraindications to BB use from cohorts of consecutively admitted cases of AMI (814 in MICH I; 500 in MICH II).


RESULTS
Prescription of BBs to ideal patients with AMI increased in patients with previous history of myocardial infarction on arrival at the hospital (12.5% vs 36.0%; P= .01), in hospital (47.0% vs 76%; P < .01), and at discharge (34.0% vs 61.9%; P < .01). Neither race nor gender was a predictor of BB use. Younger age predicted BB prescription at discharge (odds ratio [OR], 2.07; 95% confidence interval [CI], 1.32 to 3.23). Later study cohort was the most important predictor of BB use in hospital (OR, 3.4; 95% CI, 2.09 to 5.25).


CONCLUSIONS
BB use improved dramatically over the study period, but additional work is needed to improve use of BB after discharge and among elderly patients with AMI.
Olomu
Adesuwa B
AB
Department of Medicine, Michigan State University, East Lansing, MI, USA. ade.olomu@ht.msu.edu
Watson
Ralph E
RE
Siddiqi
Azfar-e-Alam
AE
Dwamena
Francesca C
FC
McIntosh
Barbara A
BA
Vasilenko
Peter
P
Kupersmith
Joel
J
Holmes-Rovner
Margaret M
MM
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization; D005260:Female; D006760:Hospitalization; D006764:Hospitals, Community; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D011446:Prospective Studies
D000319:Adrenergic beta-Antagonists