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Evidence-based therapy and its association with workforce detachment after first hospitalization for heart failure
Rørth, Rasmus Fosbøl, Emil L. Mogensen, Ulrik M. Kragholm, Kristian Jhund, Pardeep S. Petrie, Mark C. Schou, Morten Gislason, Gunnar H. McMurray, John J. V. Torp-Pedersen, Christian
Rørth, Rasmus
Fosbøl, Emil L.
Mogensen, Ulrik M.
Kragholm, Kristian
Jhund, Pardeep S.
Petrie, Mark C.
Schou, Morten
Gislason, Gunnar H.
McMurray, John J. V.
Torp-Pedersen, Christian
Abstract
Objectives: This study investigated the association between the use of evidence-based medicine (EBM) for heart failure (HF) and risk of workforce detachment. Background: The ability to work can be a marker of functional capacity and quality of life. Methods: We examined a nationwide cohort of patients in the workforce 1 year after first hospitalization for HF. EBM was defined as treatment with β-blockers and renin angiotensin system inhibitors. The fraction of target dose (0 TO 1) for each drug was calculated. The sum of the fractions gave each patient a score between 0 and 2. Patients were stratified into 4 groups according to this score: group 4 score = 2 (target dose of both drugs); group 3 score < 2 to > 1; group 2 score ≤1 to > 0.5; and group 1 score ≤0.5. The risk of subsequent workforce detachment was estimated in cause specific Cox regression models. Results: One year after first HF hospitalization, 10,185 patients were part of the workforce, and 7,561 (74%) were in treatment with at least 1 of the components of EBM. During a median follow-up of 727 days, 2,698 individuals (36%) became detached from the workforce. Patients receiving more EBM had a significantly lower risk of workforce detachment compared with those receiving less EBM (group 4 hazard ratio [HR]: 0.87; 95% confidence interval [CI]: 0.77 to 0.98; group 3 HR: 0.85; 95% CI: 0.77 to 0.94; and group 2 HR 0.92; 95% CI: 0.83 to 1.02), all compared to group 1. Conclusions: Patients in the workforce 1 year after first HF hospitalization and treated with target or near-target doses of EBM were associated with a significantly lower risk of subsequent workforce detachment.
Keywords
epidemiology, evidence-based medicine, heart failure, workforce detachment
Date
2018
Type
Journal article
Journal
JACC: Heart Failure
Book
Volume
6
Issue
1
Page Range
41-48
Article Number
ACU Department
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled