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1000 Titel
  • Patients with coronary artery disease after acute myocardial infarction: effects of continuous enrollment in a structured Disease Management Program on adherence to guideline-recommended medication, health care expenditures, and survival
1000 Autor/in
  1. Kirsch, Florian |
  2. Becker, Christian |
  3. Schramm, Anja |
  4. Maier, Werner |
  5. Leidl, Reiner |
1000 Erscheinungsjahr 2020
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2020-02-01
1000 Erschienen in
1000 Quellenangabe
  • 21(4):607-619
1000 Copyrightjahr
  • 2020
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1007/s10198-020-01158-z |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7214389/ |
1000 Publikationsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • Objective!#!Acute myocardial infarction (AMI) carries increased risk of mortality and excess costs. Disease Management Programs (DMPs) providing guideline-recommended care for chronic diseases seem an intuitively appealing way to enhance health outcomes for patients with chronic conditions such as AMI. The aim of the study is to compare adherence to guideline-recommended medication, health care expenditures and survival of patients enrolled and not enrolled in the German DMP for coronary artery disease (CAD) after an AMI from the perspective of a third-party payer over a follow-up period of 3 years.!##!Methods!#!The study is based on routinely collected data from a regional statutory health insurance fund (n = 15,360). A propensity score matching with caliper method was conducted. Afterwards guideline-recommended medication, health care expenditures, and survival between patients enrolled and not enrolled in the DMP were compared with generalized linear and Cox proportional hazard models.!##!Results!#!The propensity score matching resulted in 3870 pairs of AMI patients previously and continuously enrolled and not enrolled in the DMP. In the 3-year follow-up period the proportion of days covered rates for ACE-inhibitors (60.95% vs. 58.92%), anti-platelet agents (74.20% vs. 70.66%), statins (54.18% vs. 52.13%), and β-blockers (61.95% vs. 52.64%) were higher in the DMP group. Besides that, DMP participants induced lower health care expenditures per day (€58.24 vs. €72.72) and had a significantly lower risk of death (HR: 0.757).!##!Conclusion!#!Previous and continuous enrollment in the DMP CAD for patients after AMI is a promising strategy as it enhances guideline-recommended medication, reduces health care expenditures and the risk of death.
1000 Sacherschließung
lokal Medication Adherence/statistics
lokal I11
lokal Drug Combinations [MeSH]
lokal Coronary Artery Disease/economics [MeSH]
lokal Practice Guidelines as Topic [MeSH]
lokal Health Expenditures/statistics
lokal Disease Management [MeSH]
lokal Germany/epidemiology [MeSH]
lokal Platelet Aggregation Inhibitors/administration
lokal Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration
lokal Survival
lokal Proportional Hazards Models [MeSH]
lokal Male [MeSH]
lokal Adrenergic beta-Antagonists/administration
lokal Propensity Score [MeSH]
lokal I18
lokal Angiotensin-Converting Enzyme Inhibitors/administration
lokal AMI
lokal Female [MeSH]
lokal Coronary Artery Disease/mortality [MeSH]
lokal Insurance Claim Review [MeSH]
lokal Kaplan-Meier Estimate [MeSH]
lokal H51
lokal Humans [MeSH]
lokal Coronary Artery Disease/drug therapy [MeSH]
lokal Antibodies, Monoclonal [MeSH]
lokal Guideline-based medication
lokal Coronary Artery Disease/epidemiology [MeSH]
lokal Myocardial Infarction/epidemiology [MeSH]
lokal DMP CAD
lokal Original Paper
lokal Health care expenditures
1000 Liste der Beteiligten
  1. https://orcid.org/0000-0003-0543-592X|https://frl.publisso.de/adhoc/uri/QmVja2VyLCBDaHJpc3RpYW4=|https://frl.publisso.de/adhoc/uri/U2NocmFtbSwgQW5qYQ==|https://frl.publisso.de/adhoc/uri/TWFpZXIsIFdlcm5lcg==|https://frl.publisso.de/adhoc/uri/TGVpZGwsIFJlaW5lcg==
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1000 Erstellt am 2023-11-18T07:33:56.639+0100
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1000 Zuletzt bearbeitet 2023-12-01T12:28:38.825+0100
1000 Objekt bearb. Fri Dec 01 12:28:38 CET 2023
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