Utilization and Dose Optimization of Angiotensin-Converting Enzyme Inhibitors among Heart Failure Patients in Southwest Ethiopia

Background. Optimal use of angiotensin-converting enzyme inhibitors (ACEIs) is crucial to improve the treatment outcome in heart failure patients. However, little is known about the optimal use of ACEIs among heart failure patients in our setting. Therefore, our study aimed to investigate the utiliz...

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Bibliographic Details
Published in:BioMed research international Vol. 2019; no. 2019; pp. 1 - 8
Main Authors: Angamo, Mulugeta Tarekegn, Gidey, Kidu, Kumela Goro, Kabaye, Niriayo, Yirga Legesse
Format: Journal Article
Language:English
Published: Cairo, Egypt Hindawi Publishing Corporation 01.01.2019
Hindawi
John Wiley & Sons, Inc
Subjects:
ACE inhibitors
Adult
Age
Aged
Ambulatory care
Analysis
Angiotensin
Angiotensin-converting enzyme inhibitors
Angiotensin-Converting Enzyme Inhibitors - administration & dosage
Biomedical research
Cardiac patients
Cardiology
Cardiovascular diseases
Care and treatment
Clinical medicine
Clinical trials
Clinics
Confidence intervals
Congestive heart failure
Coronary artery disease
Cross-Sectional Studies
Diabetes mellitus
Diabetes Mellitus - drug therapy
Diuretics
Dosage
Drug dosages
Drug therapy
Drug Utilization
Emergency medical services
Enzyme inhibitors
Enzymes
Ethiopia
Evidence-based medicine
Female
Furosemide
Health care facilities
Heart diseases
Heart failure
Heart Failure - drug therapy
Heart Valve Diseases - drug therapy
Hospitalization
Hospitals
Humans
Hypertension
Hypertension - drug therapy
Male
Medical centers
Medical records
Medical research
Medicine, Experimental
Middle Aged
Morbidity
Mortality
Odds Ratio
Older people
Optimization
Outpatient Clinics, Hospital
Patients
Peptidyl-dipeptidase A
Polypharmacy
Population
Public health
Quality of life
Regression analysis
Risk analysis
Risk Factors
Statistical analysis
Studies
Treatment Outcome
Utilization
Ethiopia
ISSN:2314-6133, 2314-6141, 2314-6141
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Summary:Background. Optimal use of angiotensin-converting enzyme inhibitors (ACEIs) is crucial to improve the treatment outcome in heart failure patients. However, little is known about the optimal use of ACEIs among heart failure patients in our setting. Therefore, our study aimed to investigate the utilization and optimal dosing of ACEIs and associated factors in heart failure patients. Method. A cross-sectional study was conducted on randomly selected patients with heart failure between February 2016 and June 2016 at ambulatory care clinic of Jimma University Medical Center, Ethiopia. Data were collected through patient interview and review of medical records. Binary logistic regression analysis was done to identify factors associated with utilization and optimal dosing of ACEIs. Results. A total of 308 patients were included in the final analysis of this study. The mean (±standard deviation) age of the patients was 52.3 ±15.5 years. Out of the total, 74.7% of the patients were receiving ACEIs. Among the patients who were receiving ACEIs, only 35.7% were taking optimal dose. New York Heart Association (NYHA) class III (Adjusted odds ratio (AOR):0.12, 95% confidence interval (CI):0.02–0.98), valvular heart disease (AOR: 0.27, 95% CI: 0.13-0.56), hypertension (AOR: 5.82, 95% CI: 2.16-15.71), and diabetes mellitus (AOR: 3.84, 95% CI: 1.07-13.86) were significantly associated with the use of ACEIs, whereas age ≥65 (AOR: 2.61, 95%CI: 1.20-5.64), previous hospitalization for heart failure (AOR: 2.08, 95%CI: 1.11-3.92), diuretic use (AOR: 5.60, 95%CI: 2.75-11.40), and dose of furosemide >40mg (AOR: 9.80, 95%CI: 3.00-31.98) were predictors of suboptimal dosing of ACEIs. Conclusion. Although majority of patients were receiving ACEIs, only about one-third were using optimal dosage. Valvular heart disease and NYHA class III were negatively associated with the use of ACEIs while previous hospitalization for heart failure, old age, diuretic use, and diuretic dose were predictors of suboptimal dosing of ACEIs. Therefore, more effort needs to be done to minimize the potentially modifiable risk factors of suboptimal use of ACEIs therapy in heart failure patients.
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Academic Editor: Claudio De Lucia
ISSN:2314-6133
2314-6141
2314-6141
DOI:10.1155/2019/9463872