β-blocker compliance, mortality, and reinfarction: Validation of clinical trial association using insurer claims data

Samuel A. Kleiner, William B. Vogt, Patricia Gladowski, Andrea DeVries, Gary A Levin, Christopher Antonucci, John Fong

Research output: Contribution to journalArticle

6 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)512-519
Number of pages8
JournalAmerican Journal of Medical Quality
Volume24
Issue number6
DOIs
StatePublished - Nov 2009

Fingerprint

Insurance Carriers
Compliance
Myocardial Infarction
Clinical Trials
Mortality
Survival Rate
Survival
Prescription Drugs
Health
Randomized Controlled Trials
Demography
Research

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 journalArticle

Kleiner, Samuel A. ; Vogt, William B. ; Gladowski, Patricia ; DeVries, Andrea ; Levin, Gary A ; Antonucci, Christopher ; Fong, John. / β-blocker compliance, mortality, and reinfarction : Validation of clinical trial association using insurer claims data. In: American Journal of Medical Quality. 2009 ; Vol. 24, No. 6. pp. 512-519.
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