{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T20:20:59Z","timestamp":1793391659640,"version":"4.5.0"},"reference-count":31,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Intern Med"],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec id=\"ab-ioi260041-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Efforts to improve heart failure (HF) outcomes have focused on prescribing guideline-directed medical therapy at hospital discharge. Whether new prescriptions translate to sustained medication use after HF hospitalization is largely unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ioi260041-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To characterize medication-use patterns following HF hospitalizations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ioi260041-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>A cohort study of patients in a regional US health system discharged home after an HF hospitalization between July 1, 2017, and March 30, 2023. Data were analyzed from August 2024 to February 2026.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ioi260041-7\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Medications of interest included \u03b2-blockers, renin-angiotensin system inhibitors (RASis), mineralocorticoid receptor antagonists (MRAs), and sodium-glucose co-transporter 2 inhibitors (SGLT2is). New prescriptions were identified by in-hospital administration or discharge medication orders. Using electronic health records linked to pharmacy dispensation records, medication initiation (prescription dispensation) and primary nonadherence (discharge prescriptions that were not filled) were assessed at 7 and 90 days postdischarge. Adherence (proportion of days covered \u226580%) and persistence (continuous days\u2019 supply) were assessed over 6 months postdischarge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ioi260041-8\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This cohort study included 6111 patients with HF hospitalizations (mean [SD] age, 69.9 [13.6] years; 37.3% female [2277]) of whom 51% of were prescribed at least 1 new HF medication at discharge. At admission, 58.1% of patients were prescribed \u03b2-blockers (3549), 41.4% RASis (2530), 16.3% MRAs (997), and 4.9% SGLT2is (299); and at discharge, use increased to 73.3% (4481), 52.9% (3232), 28.5% (1740), and 9.0% (548), respectively. Primary nonadherence was observed in 51% (972 of 1904) of new prescriptions for \u03b2-blockers, 48% (659 of 1361) for RASis, 39% (482 of 1225) for MRAs, and 35% (134 of 383) for SGLT2is. Thus, of 4873 new discharge prescriptions, only 54% (2626) were initiated within 7 days of discharge and an additional 20% (954) had delayed initiation, between 7 and 90 days postdischarge. At 6 months, persistence to \u03b2-blockers was 70% (3127 of 4481), for RASis was 60% (1952 of 3232), for MRAs was 55% (961 of 1740), and for SGLT2is was 56% (306 of 548). As a result, at 6 months, only 42% (2188 of 5183) of patients were adherent and 51% (2620 of 5183) were persistent to all HF medications used at discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ioi260041-9\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>This cohort study found that following HF hospitalization, most new guideline-directed medical therapy prescriptions went unfilled. Moreover, most newly initiated prescriptions did not persist at 6 months, suggesting a need to develop interventions to support patients\u2019 medication use beyond the initial prescription at discharge.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamainternmed.2026.2908","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T15:30:44Z","timestamp":1784561444000},"page":"1155","source":"Crossref","is-referenced-by-count":3,"title":["Initiation, Adherence, and Persistence to Guideline-Directed Medical Therapy After Heart Failure Hospitalization"],"prefix":"10.1001","volume":"186","author":[{"given":"Lily G.","family":"Bessette","sequence":"first","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Department of Epidemiology, University of Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared W.","family":"Magnani","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria M.","family":"Brooks","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Department of Epidemiology, University of Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bridget M.","family":"Mayrer","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, University of Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ella","family":"Hileman-Kaplan","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gail D.","family":"Gallman","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonja A.","family":"Swanson","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Department of Epidemiology, University of Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy S.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Pittsburgh, Pennsylvania"},{"name":"Center for Pharmaceutical Policy and Prescribing, School of Medicine, University of Pittsburgh, Pennsylvania"},{"name":"Center for Healthcare Evaluation Research and Promotion, Veterans Affairs (VA) Pittsburgh Healthcare System, Pennsylvania"},{"name":"Associate Editor, JAMA Internal Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"2","key":"ioi260041r1","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1016\/j.cardfail.2025.07.007","article-title":"HF STATS 2025: heart failure epidemiology and outcomes statistics. 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