Reasons for not prescribing guideline-recommended medications to adults with heart failure.

ABSTRACT:

Background

Little is known about how often contextual factors such as patient preferences and competing priorities impact prescribing of guideline-recommended medications, or about the extent to which these factors are documented in medical records and available to performance measurement systems.

Methods

Mixed-methods study of 295 veterans aged 50 years and older in 4 VA health care systems who had systolic heart failure and were not prescribed a β-blocker and/or an angiotensin converting enzyme inhibitor or angiotensin-receptor blocker. Reasons for nontreatment were identified from clinic notes and from interviews with 62 primary care clinicians caring for these patients. These reasons were classified using a published taxonomy.

Results

Among 295 patients not receiv

SUBMITTER: Steinman MA 

PROVIDER: S-EPMC3806480 | biostudies-literature | 2013 Oct

REPOSITORIES: biostudies-literature