Author + information
- Tzy-Chyi Yu,
- Jenny Zhou,
- Dendy Macaulay,
- Huanxue Zhou,
- Stuart Turner,
- Ashok Vegesna,
- Deborah Goldschmidt,
- Olivia Liu and
- James Signorovitch
Background: Over 50% of Medicaid enrollees have a history of cardiovascular disease, including heart failure (HF). Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARB) are among guideline recommended therapies for HF patients with reduced ejection fraction. However, treatment patterns and resource use of Medicaid HF patients using ACE/ARBs have not been widely studied.
Methods: Medicaid patients with HF in 5 states in 2009-2013 were identified. The index date was the first ACE/ARB claim in 2012 (2011 for New Jersey). Patients had to be continuously enrolled in Medicaid for 1 year before (baseline) and 1 year after (follow-up) the index date. Treatment patterns and resource use were analyzed for all patients and those compliant to ACE/ARBs.
Results: The study included 10,546 HF patients using ACE/ARBs. The mean number of ACE/ARB fills during 12 months follow-up ranged from 6-9, with 23-54% of patients considered compliant. Rates of all-cause inpatient (IP) and emergency room (ER) visits were 41-55% and 49-69%, respectively; the rate of all-cause 30-day readmission was 23-34%. HF-related IP, ER, and readmission rates were 26-34%, 3-22%, and 14-16%, respectively. In general, compliant patients tended to have lower IP and ER rates and readmissions than the overall cohort.
Conclusions: High variation of ACE/ARB fill patterns and health outcomes among Medicaid HF patients in five states suggest there is opportunity for improved management in this medically complex population.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Heart Failure and Cardiomyopathies: Is Heart Failure With a Normal EF for Real?
Abstract Category: 14. Heart Failure and Cardiomyopathies: Therapy
Presentation Number: 1121-251
- 2017 American College of Cardiology Foundation