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Physicians slower to incorporate newer heart drug treatments

DALLAS An analysis of the treatment received by more than 100,000 heart patients has shown that physicians' prescription practices for drugs proven effective for treating heart disease has shown steady improvement over the past three years, cardiologists at the Duke Clinical Research Institute (DCRI) have concluded. However, they emphasized there is much room for improvement, especially in the prescription of newer heart drugs.

Use of newer medications has lagged behind that of older and more established medications, they concluded. Also, lagging has been physicians' practice of giving advice to patients upon discharge from the hospital for such behavioral modifications such as smoking cessation and diet control, said the researchers.

The overall adherence to recommended medications rose from 71 percent at the beginning of the analysis in 2002 to 81.5 percent by the end of 2004, found the researchers. The use of the older drug aspirin, for example, was consistently prescribed to more than 96 percent of heart patients, while newer drugs such as clopidogrel or glycoprotein IIb/IIIa inhibitors were consistently prescribed less than 75 percent of the time.

The researchers said that a usage rate of 95 percent or higher for the new drugs would represent a successful adherence to the guidelines.

"The good news is that we have made substantial improvements in making sure that heart patients are receiving proven medications," said Duke cardiologist Rajendra Mehta, M.D., who presented the results of the analysis Nov. 14, 2005, at the annual scientific sessions of the American Heart Association (AHA) in Dallas.

"The trends in treatment practices are very encouraging," Mehta continued. "However, there is still much work to be done, especially in improving the usage rates of some of the newer medications. It appears that physicians have been slow to incorporate the latest recommendations into their routine practice."

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Contact: Richard Merritt
Merri006@mc.duke.edu
919-684-4148
Duke University Medical Center
14-Nov-2005


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