Comparative Effectiveness of Beta-Adrenergic Antagonists on the Risk of Rehospitalization in Adults with Heart Failure. Effective Health Care Research Report No. 3

摘要

Placebo-controlled randomized trials have demonstrated the efficacy of selected Beta-blockers on outcomes in adults with heart failure, but the relative effectiveness of different Beta-blockers outside of the clinical trial setting is not well understood. The authors compared the 12-month risk of rehospitalization associated with receipt of different Beta-blockers among adults hospitalized for heart failure within two large not-for-profit health plans between January 1, 2001 and December 31, 2003. Exposure to Beta-blockers was ascertained from electronic pharmacy databases and readmissions within 12 months after discharge from the index hospitalization were identified from hospital discharge and billing claims databases. Demographic and clinical characteristics and receipt of other medications were identified from health plan administrative, ambulatory visit, hospital discharge, and pharmacy databases. Multivariable extended Cox regression was used to examine the association between receipt of different Beta-blockers and outcomes. We identified 11,396 adult members hospitalized for heart failure who had at least 12 months of continuous membership and drug benefit before the index hospitalization and during follow up until being censored or experiencing an outcome event.