WASHINGTON, May 18 /PRNewswire/ -- Less than half of heart attack survivors continue taking beta-blockers during the first year after the attack, sacrificing the lifesaving benefits of the drug, according to a study conducted by the Council for Affordable Quality Healthcare (CAQH). The findings were presented last night at the American Heart Association’s Second Annual Scientific Conference on Compliance in Healthcare and Research.
In one of the largest studies of long-term beta-blocker adherence to date, researchers performed a retrospective analysis of one-year survivors of myocardial infarction (MI), commonly known as a heart attack, and measured adherence during the first year post-MI. The study, conducted in support of CAQH’s heartBBEAT for life(R) initiative, surveyed 17,035 patients in 46 states and the District of Columbia. Data was collected through calendar year 2002. Duke Clinical Research Institute independently analyzed and presented the results.
The finding is significant because of the proven benefits of beta-blockers to heart attack survivors. According to guidelines published by the American Heart Association and the American College of Cardiology, the long-term use of beta-blockers after a heart attack can reduce the risk of another heart attack and increase the probability of long-term survival by up to 40 percent. Yet today’s study finds that many heart attack survivors discontinue beta blocker therapy soon after their heart attack.
More than 90 percent of heart attack patients are prescribed beta-blockers within seven days of leaving the hospital, according to the National Committee for Quality Assurance (NCQA). However, the new CAQH data showed that only 69 percent of patients took beta-blockers regularly during the first 30 days after their hospital discharge. Subsequently, the rate continued to decrease:
* Over the six month period after the heart attack, only 52 percent of patients had regularly taken beta-blockers. * Looking at the first year after a heart attack, only 45 percent of heart attack survivors had continued taking the therapy regularly.
“This finding raises great concern,” said Judith Kramer, M.D., the lead author of the study and principal investigator of the Duke Center for Education and Research on Therapeutics (CERTS) at the Duke Clinical Research Institute. “While we have made significant progress in the frequency of doctors prescribing beta-blockers at discharge after MI, we have not been successful at getting the patients to stay on this life-saving therapy.”
Notably, all the patients surveyed had prescription coverage. Eighty percent of the patients were covered by commercial insurance plans, and 20 percent by a Medicare+Choice plan.
If CAQH findings are extrapolated to the whole U.S. population, it would mean that more than half of approximately 7.5 million heart attack survivors in the U.S. do not take a beta-blocker regularly, skipping an effective step to decrease the risk of another heart attack and death from cardiovascular disease. Of the approximately 1.1 million heart attack cases reported in the U.S. each year, 450,000 are recurrences.
Doctor-Patient Communication Key to Raising Adherence
To better understand why patients stop taking beta-blockers, CAQH conducted additional qualitative research among patients and physicians. The findings revealed a substantial gap in doctor-patient communication, which appeared to significantly contribute to the survivors’ failure to maintain their beta-blocker regimens long-term.
The research showed that many heart attack survivors are not aware of the life-saving benefits of beta-blockers -- or do not realize that in order to achieve these benefits they must continue to take the medicine indefinitely. While most physicians believe beta-blockers are an essential part of recovery and say they would not discontinue beta-blocker treatment except in extreme cases, patients do not seem to appreciate the importance of staying on beta- blockers. At the same time, patients are often concerned about taking a medication for life, but their concerns may not be raised in discussions with their doctors.
“It appears that at some point in treatment patients begin to mistakenly believe they no longer need the drug. Heart attack survivors are much more open to maintaining beta-blocker therapy indefinitely if they understand how the medication works and the benefits of the drug,” commented John Charde, M.D., co-author, and Vice President of Health Improvement for Health Net. Dr. Charde also is co-chair of CAQH’s heartBBEAT for Life(R) initiative.
“Both physicians and their patients have a role in reducing the number of heart attack recurrences and reducing patient mortality. Physicians need the tools to provide patients with the knowledge, rationale and reinforcement to continue on beta-blocker therapies. Patients need to take their medicine, eat right and stay physically active,” Dr. Charde continued. “We are committed to supporting both sides of the equation. CAQH is currently working to develop and implement appropriate interventions to help heart attack survivors achieve the benefits of this important and life-saving treatment.”
About CAQH
The Council for Affordable Quality Healthcare (CAQH) is a not-for-profit alliance of health plans and networks that promotes collaborative initiatives to help make healthcare more affordable, share knowledge to improve the quality of care, and simplify administration for physicians and their patients. CAQH member organizations provide and administer health care coverage for more than 100 million Americans.
CAQH members include: Aetna, America’s Health Insurance Plans, Anthem Blue Cross and Blue Shield, AultCare, Blue Cross and Blue Shield Association, Blue Cross and Blue Shield of Michigan, Blue Cross and Blue Shield of North Carolina, BlueCross BlueShield of Tennessee, CareFirst BlueCross BlueShield, Empire Blue Cross Blue Shield, First Health, Great-West, Group Health Cooperative, Health Net, Highmark Blue Cross Blue Shield, Horizon Blue Cross Blue Shield of New Jersey, Independence Blue Cross, MultiPlan, Mutual of Omaha, Oxford Health Plans, The Regence Group, and WellPoint.
Contact: Julia Gusakova Erika Freed (212) 445-8242 (212) 445 8252 jgusakova@webershandwick.comefreed@webershandwick.com
Council for Affordable Quality Healthcare
CONTACT: Julia Gusakova, +1-212-445-8242, jgusakova@webershandwick.com,or Erika Freed, +1-212-445-8252, efreed@webershandwick.com, both for Councilfor Affordable Quality Healthcare
Web site: http://www.caqh.org/
