scholarly journals Adherence to recommendations for secondary prevention medications after myocardial infarction in Estonia: comparison of real-world data from 2004 to 2005 and 2017 to 2018

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Piret Lõiveke ◽  
Toomas Marandi ◽  
Tiia Ainla ◽  
Krista Fischer ◽  
Jaan Eha

Abstract Background Relatively high rates of adherence to myocardial infarction (MI) secondary prevention medications have been reported, but register-based, objective real-world data is scarce. We aimed to analyse adherence to guideline-recommended medications for secondary prevention of MI in 2017 to 2018 (period II) and compare the results with data from 2004 to 2005 (period I) in Estonia. Methods Study populations were formed based on data from the Estonian Health Insurance Fund’s database and on Estonian Myocardial Infarction Register. By linking to the Estonian Medical Prescription Centre database adherence to guideline-recommended medications for MI secondary prevention was assessed for 1 year follow-up period from the first hospitalization due to MI. Data was analysed using the defined daily dosages methodology. Results Total of 6694 and 6060 cases of MI were reported in periods I and II, respectively. At least one prescription during the follow up period was found for beta-blockers in 81.0% and 83.5% (p = 0.001), for angiotensin converting enzyme inhibitor/angiotensin II receptor blocker (ACEi/ARB) in 76.9% and 66.0% (p < 0.001), and for statins in 44.0% and 67.0% (p < 0.001) of patients in period I and II, respectively. P2Y12 inhibitors were used by 76.4% of patients in period II. The logistic regression analysis adjusted to gender and age revealed that some drugs and drug combinations were not allocated similarly in different age and gender groups. Conclusions In Estonia, adherence to MI secondary prevention guideline-recommended medications has improved. But as adherence is still not ideal more attention should be drawn to MI secondary prevention through systematic guideline implementation.

2021 ◽  
Author(s):  
Piret Lõiveke ◽  
Toomas Marandi ◽  
Tiia Ainla ◽  
Krista Fischer ◽  
Jaan Eha

Abstract Background:Relatively high rates of adherence to myocardial infarction (MI) secondary prevention medications have been reported, but register-based, objective real-world data is scarce.We aimed to analyse adherence to guideline-recommended medications for secondary prevention of MI in 2017-2018 (period II) and compare the results with data from 2004-2005 (period I) in Estonia.Methods:Study populations were formed based on data from the Estonian Health Insurance Fund's database and on Estonian Myocardial Infarction Register. By linking to the Estonian Medical Prescription Centre database adherence to guideline-recommended medications for MI secondary prevention was assessed for one year follow-up period from the first hospitalization due to MI. Data was analysed using the defined daily dosages methodology. Results:Total of 6694 and 6060 cases of MI were reported in periods I and II, respectively. At least one prescription during the follow up period was found for beta-blockers (BB) in 81.0 % and 83.5 % (p = 0.001), for angiotensin converting enzyme inhibitor/angiotensin II receptor blocker (ACEi/ARB) in 76.9 % and 66.0 % (p < 0.001), and for statins in 44.0 % and 67.0 % (p < 0.001) of patients in period I and II, respectively. P2Y12 inhibitors were used by 76.4 % of patients in period II. The logistic regression analysis adjusted to gender and age revealed that some drugs and drug combinations were not allocated similarly in different age and gender groups.Conclusions:In Estonia, adherence to MI secondary prevention guideline-recommended medications has improved. But as adherence is still not ideal more attention should be drawn to MI secondary prevention through systematic guideline implementation.


2021 ◽  
Author(s):  
Piret Lõiveke ◽  
Toomas Marandi ◽  
Tiia Ainla ◽  
Krista Fischer ◽  
Jaan Eha

Abstract Background: Relatively high rates of adherence to myocardial infarction (MI) secondary prevention medications have been reported, but register-based, objective real-world data is scarce.We aimed to analyse adherence to guideline-recommended medications for secondary prevention of MI in 2017-2018 (period II) and compare the results with data from 2004-2005 (period I) in Estonia.Methods: Study populations were formed based on data from the Estonian Health Insurance Fund's database and on Estonian Myocardial Infarction Register. By linking to the Estonian Medical Prescription Centre database adherence to guideline-recommended medications for MI secondary prevention was assessed for one year follow-up period from the first hospitalization due to MI. Data was analysed using the defined daily dosages methodology. Results: Total of 6694 and 6060 cases of MI were reported in periods I and II, respectively. At least one prescription during the follow up period was found for beta-blockers (BB) in 81.0 % and 83.5 % (p = 0.001), for angiotensin converting enzyme inhibitor/angiotensin II receptor blocker (ACEi/ARB) in 76.9 % and 66.0 % (p < 0.001), and for statins in 44.0 % and 67.0 % (p < 0.001) of patients in period I and II, respectively. P2Y12 inhibitors were used by 76.4 % of patients in period II. The logistic regression analysis adjusted to gender and age revealed that some drugs and drug combinations were not allocated similarly in different age and gender groups. Conclusions: In Estonia, adherence to MI secondary prevention guideline-recommended medications has improved. But as adherence is still not ideal more attention should be drawn to MI secondary prevention through systematic guideline implementation.


Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 928-P
Author(s):  
REEMA MODY ◽  
MARIA YU ◽  
BAL K. NEPAL ◽  
MANIGE KONIG ◽  
MICHAEL GRABNER

2019 ◽  
Vol 19 (4) ◽  
pp. 381-391 ◽  
Author(s):  
Ovidio De Filippo ◽  
Martina Cortese ◽  
Fabrizio D´Ascenzo ◽  
Sergio Raposeiras-Roubin ◽  
Emad Abu-Assi ◽  
...  

2020 ◽  
Vol 7 ◽  
pp. 237428952096822
Author(s):  
Erik J. Landaas ◽  
Ashley M. Eckel ◽  
Jonathan L. Wright ◽  
Geoffrey S. Baird ◽  
Ryan N. Hansen ◽  
...  

We describe the methods and decision from a health technology assessment of a new molecular test for bladder cancer (Cxbladder), which was proposed for adoption to our send-out test menu by urology providers. The Cxbladder health technology assessment report contained mixed evidence; predominant concerns were related to the test’s low specificity and high cost. The low specificity indicated a high false-positive rate, which our laboratory formulary committee concluded would result in unnecessary confirmatory testing and follow-up. Our committee voted unanimously to not adopt the test system-wide for use for the initial diagnosis of bladder cancer but supported a pilot study for bladder cancer recurrence surveillance. The pilot study used real-world data from patient management in the scenario in which a patient is evaluated for possible recurrent bladder cancer after a finding of atypical cytopathology in the urine. We evaluated the type and number of follow-up tests conducted including urine cytopathology, imaging studies, repeat cystoscopy evaluation, biopsy, and repeat Cxbladder and their test results. The pilot identified ordering challenges and suggested potential use cases in which the results of Cxbladder affected a change in management. Our health technology assessment provided an objective process to efficiently review test performance and guide new test adoption. Based on our pilot, there were real-world data indicating improved clinician decision-making among select patients who underwent Cxbladder testing.


2020 ◽  
Vol 22 (8) ◽  
pp. 602-612
Author(s):  
Dirk Sandig ◽  
Julia Grimsmann ◽  
Christina Reinauer ◽  
Andreas Melmer ◽  
Stefan Zimny ◽  
...  

2019 ◽  
Vol 13 (Supplement_1) ◽  
pp. S268-S269
Author(s):  
M Guerra Veloz ◽  
M Belvis Jimenez ◽  
T Valdes Delgado ◽  
L Castro Laria ◽  
B Maldonado Pérez ◽  
...  

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