Skip to main content

Main menu

  • Home
  • Content
    • Current
    • Archive
    • Podcast: NC Health Policy Forum
    • Upcoming Scientific Articles
  • Info for
    • Authors
    • Reviewers
    • Advertisers
    • Subscribers
  • About Us
    • About the North Carolina Medical Journal
    • Editorial Board
  • More
    • Alerts
    • Feedback
    • Help
    • RSS
  • Other Publications
    • North Carolina Medical Journal

User menu

  • My alerts
  • Log in

Search

  • Advanced search
North Carolina Medical Journal
  • Other Publications
    • North Carolina Medical Journal
  • My alerts
  • Log in
North Carolina Medical Journal

Advanced Search

  • Home
  • Content
    • Current
    • Archive
    • Podcast: NC Health Policy Forum
    • Upcoming Scientific Articles
  • Info for
    • Authors
    • Reviewers
    • Advertisers
    • Subscribers
  • About Us
    • About the North Carolina Medical Journal
    • Editorial Board
  • More
    • Alerts
    • Feedback
    • Help
    • RSS
  • Follow ncmj on Twitter
  • Visit ncmj on Facebook
Research ArticleOriginal Articles

Treatment of Chronic Heart Failure in a Managed Care Setting

Baseline Results from the Achieving Cardiac Excellence Project

John F. Schmedtje, Gregory W. Evans, Wesley Byerly, Mark King, Kelly Goonan, Camille Blastock-Glenn, Janet B. Croft and David C. Goff
North Carolina Medical Journal January 2003, 64 (1) 4-10; DOI: https://doi.org/10.18043/ncm.64.1.4
John F. Schmedtje Jr.
Wake Forest University School of Medicine in Winston-Salem.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: john.schmedtje@worldnet.att.net
Gregory W. Evans
Wake Forest University School of Medicine in Winston-Salem.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Wesley Byerly
Wake Forest University School of Medicine in Winston-Salem.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Mark King
Wake Forest University School of Medicine in Winston-Salem.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kelly Goonan
Wake Forest University School of Medicine in Winston-Salem.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Camille Blastock-Glenn
QualChoice of NC, Inc., in Winston-Salem. National Center for Chronic Disease Prevention and Health Promotion at the Centers for Disease Control and Prevention in Atlanta.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Janet B. Croft
QualChoice of NC, Inc., in Winston-Salem. National Center for Chronic Disease Prevention and Health Promotion at the Centers for Disease Control and Prevention in Atlanta.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
David C. Goff Jr.
Wake Forest University School of Medicine in Winston-Salem.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • References
  • Info & Metrics
  • PDF
Loading

Abstract

Background: Effective therapy for chronic heart failure (CHF) is underutilized despite a broad consensus regarding treatment recommendations. Methods: As a quality improvement project designed to reduce preventable hospitalizations associated with CHF, we examined use of angiotensin converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), and beta-adrenergic receptor blockers (BB) in a population of patients enrolled in a managed care plan. Medicare and commercial enrollees were included. Patients with CHF were identified using claims data (International Classification of Disease 9th Clinical Modification code 428) covering January 1, 1998 through December 31, 1998. Drug utilization data were obtained from the plan’s pharmacy benefits database. Data were available for 1220 patients. Results: The mean age (± SD) was 71 ± 12 years, 53% were female, and 84% were Medicare enrollees. Prescriptions for ACEI, ARB and BB were filled by 52%, 9% and 25% of patients, respectively. Prescriptions for diuretics, digitalis preparations, and calcium channel blockers (CCB) were filled by 69%, 34%, and 32%, respectively. Therefore, almost half of patients with CHF were not receiving ACEI therapy, even though it had been proven to reduce morbidity and mortality related to CHF. Furthermore, three-quarters of patients were not receiving BB therapy, a similarly effective therapy. In contrast, CCB and digitalis have not been convincingly shown to reduce mortality in patients with CHF broadly defined. Utilization of CCB and digitalis exceeded that of BB. Conclusions: Managed care organizations should develop, test, and implement network-level strategies designed to optimize the appropriate utilization of effective drug therapies for patients with CHF.

Key Words:
  • angiotensin converting enzyme inhibitors
  • beta-adrenergic antagonists
  • heart failure
  • Copyright 2003 © North Carolina Institute of Medicine
PreviousNext
Back to top

In this issue

North Carolina Medical Journal: 64 (1)
North Carolina Medical Journal
Vol. 64, Issue 1
January/February 2003
  • Table of Contents
  • Index by author
Download PDF
Email Article

Thank you for your interest in spreading the word on North Carolina Medical Journal.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Treatment of Chronic Heart Failure in a Managed Care Setting
(Your Name) has sent you a message from North Carolina Medical Journal
(Your Name) thought you would like to see the North Carolina Medical Journal web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
9 + 8 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
Treatment of Chronic Heart Failure in a Managed Care Setting
John F. Schmedtje, Gregory W. Evans, Wesley Byerly, Mark King, Kelly Goonan, Camille Blastock-Glenn, Janet B. Croft, David C. Goff
North Carolina Medical Journal Jan 2003, 64 (1) 4-10; DOI: 10.18043/ncm.64.1.4

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Treatment of Chronic Heart Failure in a Managed Care Setting
John F. Schmedtje, Gregory W. Evans, Wesley Byerly, Mark King, Kelly Goonan, Camille Blastock-Glenn, Janet B. Croft, David C. Goff
North Carolina Medical Journal Jan 2003, 64 (1) 4-10; DOI: 10.18043/ncm.64.1.4
del.icio.us logo Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
  • Info & Metrics
  • References
  • PDF

Related Articles

  • No related articles found.
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Reading, Writing, and Gaining Weight in North Carolina Schools
  • A Tribute to Francis A. Neelon, MD
  • Running the Numbers
Show more Original Articles

Similar Articles

Keywords

  • angiotensin converting enzyme inhibitors
  • beta-adrenergic antagonists
  • heart failure

About & Contact

  • About the NCMJ
  • Editorial Board
  • Feedback

Info for

  • Advertisers
  • Authors
  • Reviewers
  • Subscribers

Articles & Alerts

  • Archive
  • Current Issue
  • Get Alerts
  • Upcoming Articles

Additional Content

  • Current NCIOM Task Forces
  • NC Health Data & Resources
  • NCIOM Blog
North Carolina Medical Journal

ISSN: 0029-2559

© 2022 North Carolina Medical Journal

Powered by HighWire