{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:47:01Z","timestamp":1790063221504,"version":"4.0.1"},"reference-count":45,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,7,24]],"date-time":"2019-07-24T00:00:00Z","timestamp":1563926400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001665","name":"Agence Nationale de la Recherche","doi-asserted-by":"publisher","award":["ANR\u201015\u2010RHU\u20100004"],"award-info":[{"award-number":["ANR\u201015\u2010RHU\u20100004"]}],"id":[{"id":"10.13039\/501100001665","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The purpose of the study is to describe the trajectories of oral medication prescriptions in patients with heart failure with reduced ejection fraction (HFrEF) over 3 years after discharge from hospitalization for heart failure. We then evaluated the adherence of these prescriptions to the European Society of Cardiology (ESC) guideline\u2010recommended medications and identified patient characteristics associated with nonadherence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used data from the EPICAL2 cohort study. HFrEF patients who had completed prescriptions at discharge and at 6\u2010month follow\u2010up were included and followed for 36 months. The following medication agents were considered adherent to guidelines: renin\u2010angiotensin system (RAS) blockers [angiotensin\u2010converting enzyme inhibitor (ACEI) or an angiotensin\u2010receptor blocker (ARB)] plus a \u03b2\u2010blocker (BB) or RAS blocker plus BB plus mineralocorticoid receptor antagonists (MRAs). The evolution of drug prescriptions and the adherence to ESC guidelines were assessed by using sequence analysis and clustering approaches. Patient characteristics associated with nonadherence were identified by logistic regression analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A typology of four therapeutic clusters was obtained, among which two clusters were adherent to recommendations and two were not. The adherent clusters consisted of bitherapy (RAS blockers\u2010BB) and tritherapy (RAS blockers\u2010BB\u2010MRA) for about 64% of patients and remain stable over time. The nonadherent clusters consisted of nonprescription of BB for about 22% of patients or nonprescription of RAS blocker for about 14%. The main reason for nonprescription of BB was a concomitant obstructive airway disease (asthma or COPD) but was a concomitant chronic kidney disease for nonprescription of RAS blocker.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Adherence to guideline\u2010recommended medications while being hospitalized is of great importance because prescriptions are quite stable over time after discharge. HFrEF patients are most often older, with various comorbidities, such as chronic kidney disease or asthma\/COPD, which importantly limit physicians' ability to prescribe recommended drugs, leading to suboptimal adherence to guidelines.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.4868","type":"journal-article","created":{"date-parts":[[2019,7,24]],"date-time":"2019-07-24T14:55:43Z","timestamp":1563980143000},"page":"1489-1500","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Adherence to ESC guideline\u2010recommended medications over a 36\u2010month follow\u2010up period after hospitalization for heart failure: Results from the EPICAL2 cohort study"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8157-7447","authenticated-orcid":false,"given":"Sarah","family":"Bitar","sequence":"first","affiliation":[{"name":"CHRU\u2010Nancy, INSERM Universit\u00e9 de Lorraine, CIC, Epid\u00e9miologie Clinique  Nancy France"},{"name":"Universit\u00e9 de Lorraine, APEMAC  Nancy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelly","family":"Agrinier","sequence":"additional","affiliation":[{"name":"CHRU\u2010Nancy, INSERM Universit\u00e9 de Lorraine, CIC, Epid\u00e9miologie Clinique  Nancy France"},{"name":"Universit\u00e9 de Lorraine, APEMAC  Nancy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Alla","sequence":"additional","affiliation":[{"name":"CHRU\u2010Nancy, INSERM Universit\u00e9 de Lorraine, CIC, Epid\u00e9miologie Clinique  Nancy France"},{"name":"Universit\u00e9 de Lorraine, APEMAC  Nancy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Rossignol","sequence":"additional","affiliation":[{"name":"CHRU\u2010Nancy, INSERM Universit\u00e9 de Lorraine, CIC, Plurith\u00e9matique  Nancy France"},{"name":"F\u2010CRIN INI\u2010CRCT Network, Inserm U942  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Mebazaa","sequence":"additional","affiliation":[{"name":"F\u2010CRIN INI\u2010CRCT Network, Inserm U942  Paris France"},{"name":"Universit\u00e9 Paris Diderot, Sorbonne Paris Cit\u00e9  Paris France"},{"name":"Departement d'anesth\u00e9sie et de r\u00e9animation H\u00f4pitaux Universitaires Saint\u2010Louis Lariboisi\u00e8re, APHP  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Thilly","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lorraine, APEMAC  Nancy France"},{"name":"CHRU\u2010Nancy Universit\u00e9 de Lorraine, Plateforme d'Aide \u00e0 la Recherche Clinique  Nancy France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,24]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acvd.2014.01.012"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw128"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi251"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejheart.2008.09.008"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hfq047"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.887"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.recesp.2015.03.008"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2012.08.002"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.2459\/JCM.0000000000000038"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejheart.2007.09.008"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2014.04.255"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2004.08.060"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hft134"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2017.12.005"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000004399"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehn309"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/0049124100029001001"},{"key":"e_1_2_11_20_1","unstructured":"SchwartzT ChenQ DuanN.339\u20102011: Studying Missing Data Patterns Using a SAS\u00ae Macro.2011;4."},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/0049124110362526"},{"key":"e_1_2_11_22_1","unstructured":"Analyzing and Visualizing State Sequences in R with TraMineR|Gabadinho|Journal of Statistical Software. 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