Heart patients treated by non-cardiologists less likely to receive medications

Patients with congestive heart failure (CHF) are less likely to be discharged from the hospital with a prescription for an ACE inhibitor and other recommended medications if they are treated by a non-cardiologist, according to a study written by pharmacists at Northwestern Memorial Hospital and published January 15 in the American Journal of Health-System Pharmacy. Beta-blockers, ACE inhibitors, and aldosterone antagonists have been shown to significantly decrease morbidity and mortality and are among the medications recommended by the Heart Failure Society of America (HFSA) to treat CHF, which affects nearly 5 million Americans.

Prescribing differences were demonstrated for several key medications, including:

• ACE inhibitor (prescribed for 61 percent of patients upon discharge by cardiologists versus 35 percent by non-cardiologists)
• Beta-blocker (prescribed for 65 percent of patients upon discharge by a cardiologist versus 32 percent by non-cardiologists)
• Aldosterone antagonist (prescribed for 17 percent of patients upon discharge by a cardiologist versus 7 percent by non-cardiologists)

The study also found that cardiologists are more likely to admit a CHF patient to the Intensive Care Unit and order diagnostic tests, including chest x-rays, electrocardiograms, nuclear medicine tests, cardiac catheterizations, and stress tests, without significantly increasing a patient’s length of stay.

Study authors urge patients to take an active role in their treatment and ask about available medications. “Furthermore, patients or their family members should ask to speak to the hospital pharmacist whenever they have questions about their medicine,” explains Jean A. Patel, Pharm. D., clinical pharmacist at Northwestern Memorial Hospital and lead author of the study.

The study was co-authored by Michael A. Fotis, B.S. Pharm, manager of drug information service at Northwestern Memorial Hospital.