Abstract | CONTEXT: OBJECTIVE: DESIGN: Serial cross-sectional measurements using data from retrospective medical record abstraction. SETTING: Nongovernmental acute care hospitals in the United States. PATIENTS: Two nationally representative samples of Medicare beneficiaries hospitalized with the primary diagnosis of heart failure and concomitant diabetes between April 1998 and March 1999 and between July 2000 and June 2001. MAIN OUTCOME MEASURES: RESULTS: In the 1998-1999 sample (n = 12 505), 7.1% of patients were discharged with a prescription for metformin, 7.2% with a prescription for a thiazolidinedione, and 13.5% with a prescription for either drug. In the 2000-2001 sample (n = 13 158), metformin use increased to 11.2%, thiazolidinedione use to 16.1%, and use of either drug to 24.4% (P<.001 for all comparisons). Similar increases were seen among patients of all age groups, all races, and both sexes. CONCLUSIONS: The use of metformin and thiazolidinediones is common and has increased rapidly in Medicare beneficiaries with diabetes and heart failure in direct contrast with explicit warnings against this practice by the Food and Drug Administration. Further studies to establish the safety and effectiveness of this practice are needed to ensure optimal care of patients with diabetes and heart failure.
|
Authors | Frederick A Masoudi, Yongfei Wang, Silvio E Inzucchi, John F Setaro, Edward P Havranek, JoAnne M Foody, Harlan M Krumholz |
Journal | JAMA
(JAMA)
Vol. 290
Issue 1
Pg. 81-5
(Jul 02 2003)
ISSN: 1538-3598 [Electronic] United States |
PMID | 12837715
(Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S.)
|
Chemical References |
- Cardiotonic Agents
- Hypoglycemic Agents
- Thiazoles
- Thiazolidinediones
- Metformin
- 2,4-thiazolidinedione
|
Topics |
- Aged
- Aged, 80 and over
- Cardiotonic Agents
(therapeutic use)
- Contraindications
- Cross-Sectional Studies
- Diabetes Complications
- Diabetes Mellitus
(drug therapy)
- Drug Utilization Review
- Female
- Heart Failure
(complications, drug therapy)
- Hospitalization
- Humans
- Hypoglycemic Agents
(therapeutic use)
- Male
- Medicare
- Metformin
(therapeutic use)
- Retrospective Studies
- Thiazoles
(therapeutic use)
- Thiazolidinediones
- United States
|