TY - JOUR
T1 - β-blocker compliance, mortality, and reinfarction
T2 - Validation of clinical trial association using insurer claims data
AU - Kleiner, Samuel A.
AU - Vogt, William B.
AU - Gladowski, Patricia
AU - DeVries, Andrea
AU - Levin, Gary A
AU - Antonucci, Christopher
AU - Fong, John
PY - 2009/11
Y1 - 2009/11
N2 - Although randomized controlled trials show that long-term β-blocker use post acute myocardial infarction (AMI) reduces mortality and subsequent cardiovascular events, and that increased compliance lowers mortality, there is limited published research on the effects of long-term β-blocker compliance in observational community settings. The authors retrospectively study the effect of β-blocker compliance on mortality and repeat reinfarction using claims records from a major health insurer of all patients who were discharged alive after AMI between January 2003 and June 2004, covered by that health insurer's prescription drug coverage, and prescribed β-blockers (n = 3923). Using Cox proportional hazards regressions, they estimate both survival and AMI-free survival rates by compliance quartile. Both survival and AMI-free survival rates diverge rapidly and are robust to adjustments for demographics, DxCG risk score, and other baseline risk factors. Results suggest that patients whose post-AMI compliance with β-blocker therapy is above average experience lower mortality and reinfarction. This is especially true for high-risk patients.
AB - Although randomized controlled trials show that long-term β-blocker use post acute myocardial infarction (AMI) reduces mortality and subsequent cardiovascular events, and that increased compliance lowers mortality, there is limited published research on the effects of long-term β-blocker compliance in observational community settings. The authors retrospectively study the effect of β-blocker compliance on mortality and repeat reinfarction using claims records from a major health insurer of all patients who were discharged alive after AMI between January 2003 and June 2004, covered by that health insurer's prescription drug coverage, and prescribed β-blockers (n = 3923). Using Cox proportional hazards regressions, they estimate both survival and AMI-free survival rates by compliance quartile. Both survival and AMI-free survival rates diverge rapidly and are robust to adjustments for demographics, DxCG risk score, and other baseline risk factors. Results suggest that patients whose post-AMI compliance with β-blocker therapy is above average experience lower mortality and reinfarction. This is especially true for high-risk patients.
KW - Health services research
KW - Pharmacology/β-blockers
KW - Pharmacology/drug adherence
KW - Statistics and research methods
KW - Survival analysis
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U2 - 10.1177/1062860609345003
DO - 10.1177/1062860609345003
M3 - Article
C2 - 19890140
AN - SCOPUS:70449369621
VL - 24
SP - 512
EP - 519
JO - American Journal of Medical Quality
JF - American Journal of Medical Quality
SN - 1062-8606
IS - 6
ER -