{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T18:14:23Z","timestamp":1792088063747,"version":"4.4.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T00:00:00Z","timestamp":1659398400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003793","name":"Hj\u00e4rt-Lungfonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003793","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003246","name":"Nederlandse Organisatie voor Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003246","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["(#2019\u201001059"],"award-info":[{"award-number":["(#2019\u201001059"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013964","name":"Stiftelsen Stig och Gunborg Westman","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013964","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Heart Fail"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Half of heart failure (HF) patients have chronic kidney disease (CKD) complicating their pharmacological management. We evaluated physicians' and patients' patterns of use of evidence\u2010based medical therapies in HF across CKD stages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>\n                      We studied HF patients with reduced (HFrEF) and mildly reduced (HFmrEF) ejection fraction enrolled in the Swedish Heart Failure Registry in 2009\u20132018. We investigated the likelihood of physicians to prescribe guideline\u2010recommended therapies to patients with CKD, and of patients to fill the prescriptions within 90\u2009days of incident HF (initiating therapy), to adhere (proportion of days covered \u226580%) and persist (continued use) on these treatments during the first year of therapy. We identified 31\u2009668 patients with HFrEF (median age 74\u2009years, 46% CKD). The proportions receiving a prescription for angiotensin\u2010converting enzyme inhibitors\/angiotensin receptor blockers\/angiotensin receptor\u2013neprilysin inhibitors (ACEi\/ARB\/ARNi) were 96%, 92%, 86%, and 68%, for estimated glomerular filtration rate (eGFR) \u226560, 45\u201359, 30\u201344, and\u00a0&lt;30\u2009ml\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      , respectively; for beta\u2010blockers 94%, 93%, 92%, and 92%, for mineralocorticoid receptor antagonists (MRAs) 45%, 44%, 37%, 24%; and for triple therapy (combination of ACEi\/ARB\/ARNi\u2009+\u2009beta\u2010blockers\u2009+\u2009MRA) 38%, 35%, 28%, and 15%. Patients with CKD were less likely to initiate these medications, and less likely to adhere to and persist on ACEi\/ARB\/ARNi, MRA, and triple therapy. Among stoppers, CKD patients were less likely to restart these medications. Results were consistent after multivariable adjustment and in patients with HFmrEF (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a015\u2009114).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with HF and CKD are less likely to be prescribed and to fill prescriptions for evidence\u2010based therapies, showing lower adherence and persistence, even at eGFR categories where these therapies are recommended and have shown efficacy in clinical trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.2620","type":"journal-article","created":{"date-parts":[[2022,7,19]],"date-time":"2022-07-19T02:54:06Z","timestamp":1658199246000},"page":"2185-2195","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":66,"title":["Use of guideline\u2010recommended medical therapy in patients with heart failure and chronic kidney disease: from physician's prescriptions to patient's dispensations, medication adherence and persistence"],"prefix":"10.1093","volume":"24","author":[{"given":"Roemer J.","family":"Janse","sequence":"first","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Clinical Epidemiology Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edouard L.","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Clinical Epidemiology Leiden University Medical Center  Leiden The Netherlands"},{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women's Hospital and Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulf","family":"Dahlstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Cardiology and the Department of Health, Medicine and Caring Sciences Linkoping University  Linkoping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Benson","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bengt","family":"Lindholm","sequence":"additional","affiliation":[{"name":"Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merel","family":"van Diepen","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friedo W.","family":"Dekker","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars H.","family":"Lund","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Karolinska Institutet  Stockholm Sweden"},{"name":"Heart, Vascular and Neuro Theme Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan\u2010Jesus","family":"Carrero","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  Stockholm Sweden"},{"name":"Division of Nephrology, Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital  Stockholm 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Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,8,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.05.002"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/openhrt-2015-000324"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.02.071"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht386"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1175"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2333"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.06.072"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2007.03.011"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2008.05.028"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/03009734.2018.1490831"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejheart.2008.08.005"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs104"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.592"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-9-200905050-00006"},{"key":"e_1_2_6_16_1","first-page":"1","article-title":"KDIGO 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