ArticleBMJ open2020
Use of guideline-recommended drug therapy in patients undergoing percutaneous coronary intervention for stable coronary heart disease in Germany: a multilevel analysis of nationwide routine data.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 16 citations in OpenAlex.
- Observational
- Association of sociodemographic factors and comorbidity with non-receipt of medications for secondary prevention: a cohort study of 12,204 myocardial infarction survivors.BMC medicine · 2025Article
- Determinants of referral for suspected coronary artery disease: a qualitative study based on decision thresholds.BMC primary care · 2023Article
- Functional Evaluation of Percutaneous Coronary Intervention Based on CT Images of Three-Dimensional Reconstructed Coronary Artery Model.Contrast media & molecular imaging · 2023Article
- Circulating brain-derived neurotrophic factor dysregulation and its linkage with lipid level, stenosis degree, and inflammatory cytokines in coronary heart disease.Journal of clinical laboratory analysis · 2022Article
- Dyslipidemia Management in Patients with Coronary Artery Disease. Data from the POLASPIRE Survey.Journal of clinical medicine · 2021Article
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Authors and funding
7 authors at 7 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo determine the prescription of guideline recommended drug therapy in patients with stable coronary heart disease (sCHD) prior to percutaneous coronary intervention (PCI) in Germany and to examine the role of patient characteristics and features of regional healthcare supply in a multilevel model.
designSecondary data analysis of factors associated with the prescription of guideline recommended drug therapy using a multilevel model to analyse regional-level effects, over and above the effects of patient-level demographic and health status.
settingOffice-based prescriptions in the year prior to the invasive procedure.
participantsA linked nationwide dataset from Germany's three largest statutory health insurance funds of all patients receiving PCI in the year 2016.
main outcome measuresPatients' odds of receiving optimal medical therapy and symptom-oriented therapy within 1 year prior to PCI.
results68.6% of patients received at least one lipid-lowering drug and one symptom-oriented therapy prior to PCI. 43.6% received at least two agents to control their symptoms. Patients who received treatment in accordance with the recommendations had a greater number of diagnosed risk factors, a more severe history of cardiac disease and used a higher volume of ambulatory office-based physician services. The prescriptions prevalence for the symptom-oriented therapies differed significantly between eastern and western Germany, with a higher prevalence in the eastern districts.
conclusionsGuidelines can only provide decision-making corridors, and the applicability of recommendations must always be assessed on a case by case basis. Nevertheless, our analysis indicates that the prevalence of prescriptions in routine practice is subject to substantial variation and that conservative therapy options are not fully exhausted prior to PCI. This suggests that there might be room for improvement in the care of patients with sCHD.
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