Abstract

Objective: Chronic heart failure (CHF) is a condition that is daily confronted by clinicians in a variety of medical specialties, where physicians routinely seek optimum pharmacotherapy for their outpatients with CHF. We conducted a population- based study on pharmacotherapy for outpatients with CHF in Taiwan from 2000 to 2010, which focused on drug prescription patterns of different physician specialties. Materials and methods: We retrieved records from the National Health Insurance Research Database of patient ambulatory visits with diagnosed chronic heart failure, when cardiovascular drugs were prescribed. For purposes of this study, anti-chronic heart failure drugs were separated into categories: mortalityreducing agents (angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, β-blockers, spironolactone, hydralazine plus nitrates) and symptom-relieving agents (digoxin, diuretics). Thereafter, the trends of prescription patterns related to different physician specialties were analyzed. Results: From 2000 to 2010, the prescription rate of any mortality-reducing agent for CHF outpatients rose from 61.5% to 76.3% while the concomitant rate for digoxin decreased from 47.3% to 45.4%. Compared to internists and family physicians, cardiologists not only prescribed far more mortality-reducing agents from 2000 to 2010 (53.9 – 72.7%, 54.1 – 64.3%, 74.7 – 84.4%, respectively), but also prescribed two or three mortality-reducing drugs. Conclusion: There was a significant improvement of optimal pharmacotherapy for chronic heart failure in Taiwan. We observed that cardiologists were more aggressive than non-cardiologists when deciding whether to prescribe mortality-reducing drugs for heart failure management. However, those factors which influence the prescription patterns of internists and family physicians for their patients with CHF still require additional research.

Author Details

Authors

• Chia-Yu Chou¹,⁴,⁷,⁸
• Tzeng-Ji Chen²,³
• Shu-Chiung Chiang³
• Yu-Chun Chen³,⁹
• Ming-Hui Cheng⁵
• Yao-Chia Yang⁵
• Cheng-Hsueh Wu¹
• Chin-Chin Ho⁵
• Yu-Ju Huang⁵
• Yueh-Ching Chou⁵,⁶,⁷

Departments

• ¹ Department of Critical Care Medicine,
• ² Department of Family Medicine, Taipei Veterans General Hospital,
• ³ Institute of Hospital and Health Care Administration,
• ⁴ Institute of Health Informatics and Decision Making, School of Medicine, National Yang-Ming University,
• ⁵ Department of Pharmacy, Taipei Veterans General Hospital,
• ⁶ Department and Institute of Pharmacology, National Yang-Ming University,
• ⁷ College of Pharmacy, Taipei Medical University,
• ⁸ Department of Internal Medicine, School of Medicine, National Defense Medical Center, Taipei, Taiwan and
• ⁹ Department of Medical Research and Education, National Yang-Ming University Hospital, I-Lan, Taiwan

Address

Yueh-Ching Chou, PhD
Department of Pharmacy
Taipei Veterans General Hospital
No. 201, Sec. 2, Shi-Pai Road
Taipei, R.O.C. Taiwan
Email: [email protected]

Citation