Abstract
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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 512-519 |
| Number of pages | 8 |
| Journal | American Journal of Medical Quality |
| Volume | 24 |
| Issue number | 6 |
| DOIs | |
| State | Published - Nov 2009 |
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Keywords
- Health services research
- Pharmacology/β-blockers
- Pharmacology/drug adherence
- Statistics and research methods
- Survival analysis
ASJC Scopus subject areas
- Health Policy
Cite this
β-blocker compliance, mortality, and reinfarction : Validation of clinical trial association using insurer claims data. / Kleiner, Samuel A.; Vogt, William B.; Gladowski, Patricia; DeVries, Andrea; Levin, Gary A; Antonucci, Christopher; Fong, John.
In: American Journal of Medical Quality, Vol. 24, No. 6, 11.2009, p. 512-519.Research output: Contribution to journal › Article
}
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
UR - http://www.scopus.com/inward/record.url?scp=70449369621&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=70449369621&partnerID=8YFLogxK
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 -