title: Heart failure drug utilization patterns for Medicaid patients before and after a heart failure-related hospitalization.
abstract: The authors examined heart failure (HF) drug utilization patterns in Medicaid patients before and after a HF-related hospitalization. This was a retrospective claims analysis of Kansas Medicaid beneficiaries hospitalized for HF between July 1, 2000, and March 31, 2001. HF drugs were tracked 6 months prior and 6 months following the admission. Angiotensin-converting enzyme (ACE) inhibitor doses were compared with target ranges. The cohort of 135 patients had a mean age of 53.6 years and was predominantly female (66.7%) and Caucasian (70.4%) with a high prevalence of cardiovascular comorbidities. Before hospitalization, less than one third of patients were receiving ACE inhibitors, angiotensin receptor blockers, beta blockers, digoxin, or vasodilators. Following hospitalization, increased utilization was observed for beta blockers, digoxin, and angiotensin receptor blockers, but overall usage remained low. ACE inhibitors and vasodilator use remained constant. ACE-inhibitor doses were below target ranges before and after hospitalization. In this Medicaid cohort, HF-related hospitalizations did not lead to improved HF therapy.
authors.affiliation: Department of Pharmacy Practice, University of Kansas School of Pharmacy, University Medical Center, 3901 Rainbow Boulevard, Lawrence, KS 66160-7231, USA. phoward@kumc.edu
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Howard
authors.forename: Theresa I
authors.initials: TI
authors.lastname: Shireman
mesh_terms: D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D017723:Drug Utilization Review; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy*; D006760:Hospitalization; D006801:Humans; D007615:Kansas; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D010865:Pilot Projects; D012189:Retrospective Studies; D013997:Time Factors; D014481:United States
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D002316:Cardiotonic Agents