Evidence map›Paper›PMID 36800060›Full record

ArticleDrugs & aging2023

Implications of Under-Reporting Medication Side Effects: Beta-Blockers in Heart Failure as a Case Example.

Fabian Vargas, Joanna Bryan Ringel, Brian Yum, Emily B Levitan, Sabrina Mangal, Michael A Steinman, Monika M Safford, Parag Goyal

Open access · greenAbstract read
In one paragraph

Article in Drugs & aging, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Fabian VargasDivisions of Cardiology and General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 420 East 70th Street LH-365, New York, NY, 10021, USA.
Joanna Bryan RingelDivisions of Cardiology and General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 420 East 70th Street LH-365, New York, NY, 10021, USA.
Brian YumDivisions of Cardiology and General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 420 East 70th Street LH-365, New York, NY, 10021, USA.
Emily B LevitanDepartment of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
Sabrina MangalDivisions of Cardiology and General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 420 East 70th Street LH-365, New York, NY, 10021, USA.
Michael A SteinmanDivision of Geriatrics, University of California San Francisco, San Francisco, CA, USA.
Monika M SaffordDivisions of Cardiology and General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 420 East 70th Street LH-365, New York, NY, 10021, USA.
Parag GoyalDivisions of Cardiology and General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 420 East 70th Street LH-365, New York, NY, 10021, USA. pag9051@med.cornell.edu.ORCID http://orcid.org/0000-0001-7474-3737
Cornell University · USUniversity of Alabama at Birmingham · USUniversity of California, San Francisco · US

Funding

VCID and Stroke in a Bi-racial National CohortU01NS041588 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CUSHMAN, MARY, HOWARD, GEORGE · 2002 to 2022
$96.0M
VARC CoreP30AG044281 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Louise C. Walter · 2013 to 2026
$19.9M
REGARDS - MI StudyR01HL080477 · NHLBI · WEILL MEDICAL COLL OF CORNELL UNIV · PI LEVITAN, EMILY B, SAFFORD, MONIKA M · 2006 to 2020
$11.6M
U.S. Deprescribing Research NetworkR24AG064025 · NIA · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · PI BOYD, CYNTHIA MELINDA, STEINMAN, MICHAEL A. · 2019 to 2023
$9.9M
Prescribing cascades in older adults with and without dementiaK24AG049057 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI STEINMAN, MICHAEL A. · 2015 to 2025
$1.8M
A Novel Deprescribing Intervention for Heart Failure with Preserved Ejection Fraction (HFpEF): A Prototype for Older Adults with Multimorbidity and PolypharmacyK76AG064428 · NIA · WEILL MEDICAL COLL OF CORNELL UNIV · PI GOYAL, PARAG · 2020 to 2024
$1.1M
Impact of Polypharmacy on Rehospitalization in Older Adults with Heart FailureR03AG056446 · NIA · WEILL MEDICAL COLL OF CORNELL UNIV · PI GOYAL, PARAG · 2017 to 2018
$265k
NHLBI NIH HHS R01 HL080477NIA NIH HHS K24 AG049057NIA NIH HHS K76 AG064428NIA NIH HHS P30 AG044281NIA NIH HHS R03 AG056446NIA NIH HHS R24 AG064025NINDS NIH HHS U01 NS041588
6 · The paper itself

Abstract

introductionPerceiving medication side effects but not reporting them to a clinician is common. Patterns of "under-reporting" and their implications are not well described. We aimed to address this gap by examining patterns of under-reporting perceived side effects of beta-blockers among patients with heart failure.

methodsIn 2016, a survey that evaluated medication-taking behavior was administered to 1114 participants (46.5% response rate) from The Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort with prior adjudicated heart failure hospitalization or a heart failure Medicare claim. We examined the results of survey respondents who reported taking a beta-blocker to understand patterns of under-reporting perceived beta-blocker side effects. We defined an under-reporter as a participant who perceived experiencing a side effect from their beta-blocker but did not share it with their clinician (according to survey responses). We conducted a multivariable logistic regression analysis to identify determinants of being an under-reporter. Co-variates included age, sex, race, income, level of education, geographical location, and pill burden. We also examined whether under-reporters differed in self-reported medication adherence and willingness to take additional medication to prevent a future healthcare encounter compared to participants who reported perceived side effects to their clinicians and those who did not experience side effects.

resultsAmong 310 respondents, 28% (n = 87) were under-reporters. Black race (odds ratio 2.11, confidence interval 1.21-3.67) and education less than college (odds ratio 2.00, confidence interval 1.09-3.67) were associated with being an under-reporter. Self-reported medication adherence was similar between groups (under-reporters: 46.3%; those who reported perceived side effects: 49.4%; those who did not experience side effects: 45.0%); under-reporters were more frequently unwilling to take additional medication to prevent a doctor's visit (18.9% vs 12.1% vs 10.8%), emergency room visit (21.6% vs 13.3% vs 9.9%), and hospitalization (17.6% vs 10.8% vs 9.0%) compared with the other groups.

conclusionWe conclude that under-reporting perceived side effects of beta-blockers among adults with heart failure is common, is associated with Black race and low education, and may contribute to patient willingness to take additional medication to prevent future medical encounters.

Indexed as

Drug-Related Side Effects and Adverse ReactionsHeart FailureAdrenergic beta-AntagonistsAgedHospitalizationHumansMedicareMedication AdherenceUnited StatesAdrenergic beta-Antagonists

Identifiers

PMID36800060
PMCPMC10900534
OpenAlexW4321168477

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.