{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:14:01Z","timestamp":1790072041553,"version":"4.0.1"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,8,18]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Patients hospitalized with heart failure (HF) with reduced ejection fraction have high risk of rehospitalization or death. Despite guideline recommendations based on high\u2010quality evidence, a substantial proportion of patients with HF with reduced ejection fraction receive suboptimal care and\/or do not comply with optimal care following hospitalization.<\/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\">This retrospective observational study identified 17\u00a0106 patients with HF with reduced ejection fraction with an incident HF\u2010related hospitalization using the Humana Medicare Advantage database (2008\u20132016). HF medication classes (beta\u2010blockers, angiotensin\u2010converting enzyme inhibitors, angiotensin receptor blockers, angiotensin receptor neprilysin inhibitors, or mineralocorticoid receptor antagonists) received in the year after hospitalization were recorded, and categorized by treatment intensity (ie, number of concomitant medication classes received: none [23% of patients; n=3987], monotherapy [22%; n=3777], dual therapy [41%; n=7056], or triple therapy [13%; n=2286]). Compared with no medication, risk of primary outcome (composite of death or rehospitalization) was significantly reduced (hazard ratio [95% CI]) with monotherapy (0.68 [0.64\u20130.71]), dual therapy (0.56 [0.53\u20130.59]), and triple therapy (0.45 [0.41\u20130.50]). Nearly half (46%) of patients who received post\u2010discharge medication had no dose escalation. Overall, 59% of patients had follow\u2010up with a primary care physician within 14\u00a0days of discharge, and 23% had follow\u2010up with a cardiologist.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In real\u2010world clinical practice, increasing treatment intensity reduced risk of death and rehospitalization among patients hospitalized for HF, though the use of guideline\u2010recommended dual and triple HF therapy remained low. There are opportunities to improve post\u2010discharge medical management for patients with HF with reduced ejection fraction such as optimizing dose titration and improving post\u2010discharge follow\u2010up with providers.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.015042","type":"journal-article","created":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T08:53:02Z","timestamp":1596531182000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":65,"title":["Real\u2010World Analysis of Guideline\u2010Based Therapy After Hospitalization for Heart Failure"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4755-7159","authenticated-orcid":false,"given":"Heidi S.","family":"Wirtz","sequence":"first","affiliation":[{"name":"Amgen Inc. Thousand Oaks CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Sheer","sequence":"additional","affiliation":[{"name":"Humana Healthcare Research Inc. Louisville KY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narimon","family":"Honarpour","sequence":"additional","affiliation":[{"name":"Amgen Inc. Thousand Oaks CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrianne W.","family":"Casebeer","sequence":"additional","affiliation":[{"name":"Humana Healthcare Research Inc. Louisville KY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff D.","family":"Simmons","sequence":"additional","affiliation":[{"name":"Humana Inc. Louisville KY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher E.","family":"Kurtz","sequence":"additional","affiliation":[{"name":"Amgen Inc. Thousand Oaks CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret K.","family":"Pasquale","sequence":"additional","affiliation":[{"name":"Humana Healthcare Research Inc. Louisville KY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Globe","sequence":"additional","affiliation":[{"name":"Amgen Inc. Thousand Oaks CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0b013e31829e8776"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2007.80"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa020265"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.292.3.344"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2016.22.5.561"},{"key":"e_1_3_2_7_2","first-page":"769","article-title":"Costs of heart failure\u2010related hospitalizations in patients aged 18 to 64 years","volume":"16","author":"Wang G","year":"2010","unstructured":"Wang G, Zhang Z, Ayala C, Wall HK, Fang J. Costs of heart failure\u2010related hospitalizations in patients aged 18 to 64 years. Am J Manag Care. 2010;16:769\u2013776.","journal-title":"Am J Manag Care"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.748"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.109.883256"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.11.025"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000509"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.04.070"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2004.03.004"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2011.01.027"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.510"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.533"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/pds.2146"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.111.000018"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2003.12.040"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.932"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.01.041"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2015.14"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.09.038"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-017-0618-4"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.004675"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.180786"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.116.003194"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2009.07.031"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.887"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.116.003529"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1097\/MJT.0000000000000791"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.008789"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.471"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.119.015042","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:57:49Z","timestamp":1715601469000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.119.015042"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,18]]},"references-count":32,"journal-issue":{"issue":"16","published-print":{"date-parts":[[2020,8,18]]}},"alternative-id":["10.1161\/JAHA.119.015042"],"URL":"https:\/\/doi.org\/10.1161\/jaha.119.015042","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,18]]},"assertion":[{"value":"2019-10-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e015042"}}