{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T15:32:27Z","timestamp":1761060747890,"version":"3.41.2"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,2,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The angiotensin\u2010receptor\/neprilysin inhibitor (\n              <jats:styled-content style=\"fixed-case\">ARNI<\/jats:styled-content>\n              ) sacubitril\/valsartan reduces hospitalization and mortality for patients with heart failure with reduced ejection fraction. However, adoption of\n              <jats:styled-content style=\"fixed-case\">ARNI<\/jats:styled-content>\n              into clinical practice has been slow. Factors influencing use of\n              <jats:styled-content style=\"fixed-case\">ARNI<\/jats:styled-content>\n              have not been fully elucidated. Using data from the Get With The Guidelines\u2010Heart Failure registry, Hospital Compare, Dartmouth Atlas, and the American Hospital Association Survey, we sought to identify hospital characteristics associated with patient\u2010level receipt of an\n              <jats:styled-content style=\"fixed-case\">ARNI<\/jats:styled-content>\n              prescription.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We analyzed patients with heart failure with reduced ejection fraction who were eligible for\n              <jats:styled-content style=\"fixed-case\">ARNI<\/jats:styled-content>\n              prescription (ejection fraction\u226440%, no contraindications) and hospitalized from October 1, 2015 through December 31, 2016. We used logistic regression to estimate the associations between hospital characteristics and patient\n              <jats:styled-content style=\"fixed-case\">ARNI<\/jats:styled-content>\n              prescription at hospital discharge, accounting for clustering of patients within hospitals using generalized estimating equation\u00a0methods and adjusting for patient\u2010level covariates. Of 16\u00a0674 eligible hospitalizations from 210 hospitals, 1020 patients (6.1%) were prescribed\n              <jats:styled-content style=\"fixed-case\">ARNI<\/jats:styled-content>\n              at discharge. The median hospital\u2010level proportion of patients prescribed\n              <jats:styled-content style=\"fixed-case\">ARNI<\/jats:styled-content>\n              was 3.3% (Q1, Q3: 0%, 12.6%). After adjustment for patient\u2010level covariates, for\u2010profit hospitals had significantly higher odds of\n              <jats:styled-content style=\"fixed-case\">ARNI<\/jats:styled-content>\n              prescription compared with not\u2010for\u2010profit hospitals (odds ratio, 2.53; 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 1.05\u20136.10;\n              <jats:italic>P<\/jats:italic>\n              =0.04), and hospitals located in the Western United States had lower odds of\n              <jats:styled-content style=\"fixed-case\">ARNI<\/jats:styled-content>\n              prescription compared with those in the Northeast (odds ratio, 0.33; 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 0.13\u20130.84;\n              <jats:italic>P<\/jats:italic>\n              =0.02).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Relatively few hospital characteristics were associated with\n              <jats:styled-content style=\"fixed-case\">ARNI<\/jats:styled-content>\n              prescription at hospital discharge, in contrast to what has been observed in early adoption in other disease areas. Additional evaluation of barriers to implementing new evidence into heart failure practice is needed.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.118.010484","type":"journal-article","created":{"date-parts":[[2019,2,3]],"date-time":"2019-02-03T10:01:56Z","timestamp":1549188116000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Relationship Between Hospital Characteristics and Early Adoption of Angiotensin\u2010Receptor\/Neprilysin Inhibitor Among Eligible Patients Hospitalized for Heart Failure"],"prefix":"10.1161","volume":"8","author":[{"given":"Nancy","family":"Luo","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine University of California\u2014Davis Medical Center Sacramento CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven J.","family":"Lippmann","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences Duke University School of Medicine Durham NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert J.","family":"Mentz","sequence":"additional","affiliation":[{"name":"Department of Medicine Duke University School of Medicine Durham NC"},{"name":"Duke Clinical Research Institute Duke University School of Medicine Durham NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa A.","family":"Greiner","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences Duke University School of Medicine Durham NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bradley G.","family":"Hammill","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences Duke University School of Medicine Durham NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N. Chantelle","family":"Hardy","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences Duke University School of Medicine Durham NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Warren K.","family":"Laskey","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of New Mexico School of Medicine Albuquerque NM"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul A.","family":"Heidenreich","sequence":"additional","affiliation":[{"name":"Department of Medicine Veterans Affairs Palo Alto Health Care System Palo Alto CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun\u2010Lan","family":"Chang","sequence":"additional","affiliation":[{"name":"US Health Economics &amp; Outcomes Research Novartis Pharmaceuticals Corporation East Hanover NJ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian F.","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Department of Medicine Duke University School of Medicine Durham NC"},{"name":"Duke Clinical Research Institute Duke University School of Medicine Durham NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lesley H.","family":"Curtis","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences Duke University School of Medicine Durham NC"},{"name":"Duke Clinical Research Institute Duke University School of Medicine Durham NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pamela N.","family":"Peterson","sequence":"additional","affiliation":[{"name":"Department of Medicine Denver Health Medical Center Denver CO"},{"name":"Anschutz Medical Center University of Colorado Aurora CO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregg C.","family":"Fonarow","sequence":"additional","affiliation":[{"name":"Ahmanson\u2010UCLA Cardiomyopathy Center University of California Los Angeles CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily C.","family":"O'Brien","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences Duke University School of Medicine Durham NC"},{"name":"Duke Clinical Research Institute Duke University School of Medicine Durham NC"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1409077"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000435"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.7326\/M16-0057"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2016.02.007"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2016.1747"},{"key":"e_1_3_1_7_2","article-title":"Angiotensin\u2010neprilysin inhibition in acute decompensated heart failure","author":"Velazquez EJ","unstructured":"Velazquez EJ, Morrow DA, DeVore AD, Duffy CI, Ambrosy AP, McCague K, Rocha R, Braunwald E. 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