التفاصيل البيبلوغرافية
| العنوان: |
Cohort profile: a large EHR-based cohort with linked pharmacy refill and neighbourhood social determinants of health data to assess heart failure medication adherence |
| المؤلفون: |
Adhikari, Samrachana, Mukhyopadhyay, Amrita, Kolzoff, Samuel, Li, Xiyue, Nadel, Talia, Fitchett, Cassidy, Chunara, Rumi, Dodson, John, Kronish, Ian, Blecker, Saul B |
| المساهمون: |
National Heart, Lung, and Blood Institute, American Heart Association, Directorate for Computer and Information Science and Engineering |
| المصدر: |
BMJ Open ; volume 13, issue 12, page e076812 ; ISSN 2044-6055 2044-6055 |
| بيانات النشر: |
BMJ |
| سنة النشر: |
2023 |
| مصطلحات موضوعية: |
General Medicine |
| الوصف: |
Purpose Clinic-based or community-based interventions can improve adherence to guideline-directed medication therapies (GDMTs) among patients with heart failure (HF). However, opportunities for such interventions are frequently missed, as providers may be unable to recognise risk patterns for medication non-adherence. Machine learning algorithms can help in identifying patients with high likelihood of non-adherence. While a number of multilevel factors influence adherence, prior models predicting non-adherence have been limited by data availability. We have established an electronic health record (EHR)-based cohort with comprehensive data elements from multiple sources to improve on existing models. We linked EHR data with pharmacy refill data for real-time incorporation of prescription fills and with social determinants data to incorporate neighbourhood factors. Participants Patients seen at a large health system in New York City (NYC), who were >18 years old with diagnosis of HF or reduced ejection fraction (<40%) since 2017, had at least one clinical encounter between 1 April 2021 and 31 October 2022 and active prescriptions for any of the four GDMTs (beta-blocker, ACEi/angiotensin receptor blocker (ARB)/angiotensin receptor neprilysin inhibitor (ARNI), mineralocorticoid receptor antagonist (MRA) and sodium-glucose cotransporter 2 inhibitor (SGLT2i)) during the study period. Patients with non-geocodable address or outside the continental USA were excluded. Findings to date Among 39 963 patients in the cohort, the average age was 73±14 years old, 44% were female and 48% were current/former smokers. The common comorbid conditions were hypertension (77%), cardiac arrhythmias (56%), obesity (33%) and valvular disease (33%). During the study period, 33 606 (84%) patients had an active prescription of beta blocker, 32 626 (82%) had ACEi/ARB/ARNI, 11 611 (29%) MRA and 7472 (19%) SGLT2i. Ninety-nine per cent were from urban metropolitan areas. Future plans We will use the established cohort to develop a machine ... |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
English |
| DOI: |
10.1136/bmjopen-2023-076812 |
| الإتاحة: |
https://doi.org/10.1136/bmjopen-2023-076812Test |
| حقوق: |
http://creativecommons.org/licenses/by-nc/4.0Test/ |
| رقم الانضمام: |
edsbas.D78AF34 |
| قاعدة البيانات: |
BASE |
