PMID- 26883900
OWN - NLM
STAT- MEDLINE
DCOM- 20170620
LR  - 20181202
IS  - 1615-6692 (Electronic)
IS  - 0340-9937 (Linking)
VI  - 41
IP  - 7
DP  - 2016 Nov
TI  - [Impact of guideline adherence on mortality in treatment of left heart failure].
PG  - 614-624
AB  - BACKGROUND: The German national guidelines on chronic heart failure provide 
      treatment recommendations to physicians and reflect the current level of 
      evidence; however, it is questionable to what extent these recommendations are 
      applied in the routine practice and what the effect of guideline adherence on 
      mortality is. METHODS: In this study the claims data of a major German health 
      insurance fund collected over a period of 4 years were analyzed. Using binary 
      logistic regression and Cox regression analyses the influence of drug 
      prescriptions, diagnostic measures, influenza vaccination, the New York Heart 
      Association (NYHA) status, the age and gender on mortality were examined. 
      RESULTS: The study population consisted of 85,465 heart failure patients. 
      Approximately 60 % of the drugs were prescribed according to the guidelines. 
      There was a positive correlation between a higher NYHA status and mortality with 
      an odds ratio (OR) of 3.264. Especially pharmacotherapy with 
      angiotensin-converting enzyme (ACE) inhibitors and beta blockers according to the 
      guidelines was associated with a lower mortality rate (OR 0.448 resp. 0.444). 
      Also patients diagnosed using echocardiography at regular intervals showed a 
      lower risk of dying (OR 0.314). CONCLUSION: The results of this large sample 
      could confirm the results of clinical trials that a therapy according to the 
      guidelines has a significant impact on mortality. By analyzing the claims data 
      evidence was found that in the treatment of heart failure patients the medical 
      results could be improved by adherence to guideline recommendations.
FAU - Neubauer, S
AU  - Neubauer S
AD  - Leibniz Universitat Hannover, Center for Health Economics Research Hannover 
      (CHERH), Hannover, Deutschland. sn@cherh.de.
FAU - Schilling, T
AU  - Schilling T
AD  - Medizinische Hochschule Hannover, Klinik fur Herz-, Thorax-, Transplantations- 
      und Gefasschirurgie (HTTG), Hannover, Deutschland.
FAU - Zeidler, J
AU  - Zeidler J
AD  - Leibniz Universitat Hannover, Center for Health Economics Research Hannover 
      (CHERH), Hannover, Deutschland.
FAU - Lange, A
AU  - Lange A
AD  - Leibniz Universitat Hannover, Center for Health Economics Research Hannover 
      (CHERH), Hannover, Deutschland.
FAU - Engel, S
AU  - Engel S
AD  - Techniker Krankenkasse, Wissenschaftliches Institut fur Nutzen und Effizienz im 
      Gesundheitswesen (WINEG), Hamburg, Deutschland.
FAU - Linder, R
AU  - Linder R
AD  - Techniker Krankenkasse, Wissenschaftliches Institut fur Nutzen und Effizienz im 
      Gesundheitswesen (WINEG), Hamburg, Deutschland.
FAU - Verheyen, F
AU  - Verheyen F
AD  - Techniker Krankenkasse, Wissenschaftliches Institut fur Nutzen und Effizienz im 
      Gesundheitswesen (WINEG), Hamburg, Deutschland.
FAU - von der Schulenburg, J-M Graf
AU  - von der Schulenburg JG
AD  - Leibniz Universitat Hannover, Center for Health Economics Research Hannover 
      (CHERH), Hannover, Deutschland.
FAU - Haverich, A
AU  - Haverich A
AD  - Medizinische Hochschule Hannover, Klinik fur Herz-, Thorax-, Transplantations- 
      und Gefasschirurgie (HTTG), Hannover, Deutschland.
LA  - ger
PT  - Journal Article
TT  - Auswirkung einer leitliniengerechten Behandlung auf die Mortalitat bei 
      Linksherzinsuffizienz.
DEP - 20160216
PL  - Germany
TA  - Herz
JT  - Herz
JID - 7801231
RN  - 0 (Cardiotonic Agents)
SB  - IM
MH  - Age Distribution
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiology/standards
MH  - Cardiotonic Agents/standards/*therapeutic use
MH  - Echocardiography/*standards/statistics & numerical data
MH  - Female
MH  - Germany/epidemiology
MH  - Guideline Adherence/standards/*statistics & numerical data
MH  - Heart Failure/diagnosis/*mortality/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Practice Guidelines as Topic
MH  - Prevalence
MH  - Risk Factors
MH  - Sex Distribution
MH  - Survival Rate
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Claims data
OT  - Guideline adherence
OT  - Heart failure
OT  - Mortality
OT  - Pharmacotherapy
EDAT- 2016/10/23 06:00
MHDA- 2017/06/21 06:00
CRDT- 2016/02/18 06:00
PHST- 2015/11/24 00:00 [received]
PHST- 2016/01/08 00:00 [accepted]
PHST- 2016/01/04 00:00 [revised]
PHST- 2016/10/23 06:00 [pubmed]
PHST- 2017/06/21 06:00 [medline]
PHST- 2016/02/18 06:00 [entrez]
AID - 10.1007/s00059-016-4401-0 [pii]
AID - 10.1007/s00059-016-4401-0 [doi]
PST - ppublish
SO  - Herz. 2016 Nov;41(7):614-624. doi: 10.1007/s00059-016-4401-0. Epub 2016 Feb 16.