064 Temporal trends in prescription rates of recommended treatments in chronic heart failure outpatients: a comparison of three French surveys IMPACT RECO I, II & III

Abstract

Recent registries have shown that recommended drugs for the treatment of congestive heart failure (CHF) remain under-prescribed in daily practice. To compare prescription rates of CHF drugs in three French surveys Impact Reco I, II and III. We included outpatients followed by private cardiologists: 1947 in Impact Reco I (2005), 1974 in Impact Reco II (2005/2006) and 1574 in Impact Reco III (2007), with NYHA class II-IV heart failure and a left ventricular ejection fraction < 40%, and we compared treatment modalities. Recommended treatments and target doses were defined according to ESC guidelines. There was an improvement in both the rate of prescription, and in the proportion of patients reaching target dose or 50% of target dose of ACE I, ARBs and beta blockers (see table). We observed an improvement with time in the management of CHF outpatients with an increase in prescription rates of recommended CHF drugs, as well as in the dosage used for ACE-I, ARB and beta-blockers, Prescription IMPACT I 2005 IMPACT II 2005/2006 IMPACT III 2007 Global population 1917 1974 1574 ACE I Number patients with prescription N (%) 1361 (71.0) 1349 (68.3) 1099 (70.2) Target dose % 48.7 57.3 * 52.3 • 50% Target dose % 80.4 84.5 * 88.4 † , • ARBs Number patients with prescription N (%) 395 (20.6) 592 (30.0) * 516 (33.3) † , • Target dose % 9.1 7.4 20.7 † , • 50% Target dose % 52.9 49.7 68.6 † , • Betablockers Number patients with prescription N (%) 1245 (65.2) 1382 (70.0) * 1229 (78.3) † , • Target dose % 18.4 23.4 * 25.7 † 50% Target dose % 47.3 53.5 * 59.9 †• * : p<0.05 Impact II vs I • : p<0.05 Impact III vs II † : p<0.05 Impact III vs I although there is still room for improvement particularly for beta blockers. These encouraging findings suggest a better awareness and implementation of ESC guidelines by French private cardiologists.