[Impact of guideline adherence on mortality in treatment of left heart failure].
Identifieur interne : 000082 ( Main/Exploration ); précédent : 000081; suivant : 000083[Impact of guideline adherence on mortality in treatment of left heart failure].
Auteurs : S. Neubauer [Allemagne] ; T. Schilling [Allemagne] ; J. Zeidler [Allemagne] ; A. Lange [Allemagne] ; S. Engel [Allemagne] ; R. Linder [Allemagne] ; F. Verheyen [Allemagne] ; J-M Graf Von Der Schulenburg [Allemagne] ; A. Haverich [Allemagne]Source :
- Herz [ 1615-6692 ] ; 2016.
Descripteurs français
- KwdFr :
- Adhésion aux directives (normes), Adhésion aux directives (statistiques et données numériques), Adulte d'âge moyen (MeSH), Allemagne (épidémiologie), Cardiologie (normes), Cardiotoniques (normes), Cardiotoniques (usage thérapeutique), Défaillance cardiaque (diagnostic), Défaillance cardiaque (mortalité), Défaillance cardiaque (thérapie), Facteurs de risque (MeSH), Femelle (MeSH), Guides de bonnes pratiques cliniques comme sujet (MeSH), Humains (MeSH), Mâle (MeSH), Prévalence (MeSH), Répartition par sexe (MeSH), Répartition par âge (MeSH), Résultat thérapeutique (MeSH), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Taux de survie (MeSH), Échocardiographie (normes), Échocardiographie (statistiques et données numériques).
- MESH :
- diagnostic : Défaillance cardiaque.
- mortalité : Défaillance cardiaque.
- normes : Adhésion aux directives, Cardiologie, Cardiotoniques, Échocardiographie.
- statistiques et données numériques : Adhésion aux directives, Échocardiographie.
- thérapie : Défaillance cardiaque.
- usage thérapeutique : Cardiotoniques.
- épidémiologie : Allemagne.
- Adulte d'âge moyen, Facteurs de risque, Femelle, Guides de bonnes pratiques cliniques comme sujet, Humains, Mâle, Prévalence, Répartition par sexe, Répartition par âge, Résultat thérapeutique, Sujet âgé, Sujet âgé de 80 ans ou plus, Taux de survie.
English descriptors
- KwdEn :
- Age Distribution (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Cardiology (standards), Cardiotonic Agents (standards), Cardiotonic Agents (therapeutic use), Echocardiography (standards), Echocardiography (statistics & numerical data), Female (MeSH), Germany (epidemiology), Guideline Adherence (standards), Guideline Adherence (statistics & numerical data), Heart Failure (diagnosis), Heart Failure (mortality), Heart Failure (therapy), Humans (MeSH), Male (MeSH), Middle Aged (MeSH), Practice Guidelines as Topic (MeSH), Prevalence (MeSH), Risk Factors (MeSH), Sex Distribution (MeSH), Survival Rate (MeSH), Treatment Outcome (MeSH).
- MESH :
- chemical , standards : Cardiotonic Agents.
- diagnosis : Heart Failure.
- epidemiology : Germany.
- mortality : Heart Failure.
- standards : Cardiology, Echocardiography, Guideline Adherence.
- statistics & numerical data : Echocardiography, Guideline Adherence.
- chemical , therapeutic use : Cardiotonic Agents.
- therapy : Heart Failure.
- Age Distribution, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Practice Guidelines as Topic, Prevalence, Risk Factors, Sex Distribution, Survival Rate, Treatment Outcome.
Abstract
BACKGROUND
The German national guidelines on chronic heart failure provide treatment recommendations to physicians and reflect the current level of evidence; however, it is questionable to what extent these recommendations are applied in the routine practice and what the effect of guideline adherence on mortality is.
METHODS
In this study the claims data of a major German health insurance fund collected over a period of 4 years were analyzed. Using binary logistic regression and Cox regression analyses the influence of drug prescriptions, diagnostic measures, influenza vaccination, the New York Heart Association (NYHA) status, the age and gender on mortality were examined.
RESULTS
The study population consisted of 85,465 heart failure patients. Approximately 60 % of the drugs were prescribed according to the guidelines. There was a positive correlation between a higher NYHA status and mortality with an odds ratio (OR) of 3.264. Especially pharmacotherapy with angiotensin-converting enzyme (ACE) inhibitors and beta blockers according to the guidelines was associated with a lower mortality rate (OR 0.448 resp. 0.444). Also patients diagnosed using echocardiography at regular intervals showed a lower risk of dying (OR 0.314).
CONCLUSION
The results of this large sample could confirm the results of clinical trials that a therapy according to the guidelines has a significant impact on mortality. By analyzing the claims data evidence was found that in the treatment of heart failure patients the medical results could be improved by adherence to guideline recommendations.
DOI: 10.1007/s00059-016-4401-0
PubMed: 26883900
Affiliations:
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Engel</name><affiliation wicri:level="3"><nlm:affiliation>Techniker Krankenkasse, Wissenschaftliches Institut für Nutzen und Effizienz im Gesundheitswesen (WINEG), Hamburg, Deutschland.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Techniker Krankenkasse, Wissenschaftliches Institut für Nutzen und Effizienz im Gesundheitswesen (WINEG), Hamburg</wicri:regionArea><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation></author><author><name sortKey="Linder, R" sort="Linder, R" uniqKey="Linder R" first="R" last="Linder">R. Linder</name><affiliation wicri:level="3"><nlm:affiliation>Techniker Krankenkasse, Wissenschaftliches Institut für Nutzen und Effizienz im Gesundheitswesen (WINEG), Hamburg, Deutschland.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Techniker Krankenkasse, Wissenschaftliches Institut für Nutzen und Effizienz im Gesundheitswesen (WINEG), Hamburg</wicri:regionArea><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation></author><author><name sortKey="Verheyen, F" sort="Verheyen, F" uniqKey="Verheyen F" first="F" last="Verheyen">F. Verheyen</name><affiliation wicri:level="3"><nlm:affiliation>Techniker Krankenkasse, Wissenschaftliches Institut für Nutzen und Effizienz im Gesundheitswesen (WINEG), Hamburg, Deutschland.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Techniker Krankenkasse, Wissenschaftliches Institut für Nutzen und Effizienz im Gesundheitswesen (WINEG), Hamburg</wicri:regionArea><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation></author><author><name sortKey="Von Der Schulenburg, J M Graf" sort="Von Der Schulenburg, J M Graf" uniqKey="Von Der Schulenburg J" first="J-M Graf" last="Von Der Schulenburg">J-M Graf Von Der Schulenburg</name><affiliation wicri:level="3"><nlm:affiliation>Leibniz Universität Hannover, Center for Health Economics Research Hannover (CHERH), Hannover, Deutschland.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Leibniz Universität Hannover, Center for Health Economics Research Hannover (CHERH), Hannover</wicri:regionArea><placeName><region type="land" nuts="2">Basse-Saxe</region><settlement type="city">Hanovre</settlement></placeName></affiliation></author><author><name sortKey="Haverich, A" sort="Haverich, A" uniqKey="Haverich A" first="A" last="Haverich">A. Haverich</name><affiliation wicri:level="3"><nlm:affiliation>Medizinische Hochschule Hannover, Klinik für Herz-, Thorax-, Transplantations- und Gefäßchirurgie (HTTG), Hannover, Deutschland.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Medizinische Hochschule Hannover, Klinik für Herz-, Thorax-, Transplantations- und Gefäßchirurgie (HTTG), Hannover</wicri:regionArea><placeName><region type="land" nuts="2">Basse-Saxe</region><settlement type="city">Hanovre</settlement></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2016">2016</date><idno type="RBID">pubmed:26883900</idno><idno type="pmid">26883900</idno><idno type="doi">10.1007/s00059-016-4401-0</idno><idno type="wicri:Area/Main/Corpus">000077</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000077</idno><idno type="wicri:Area/Main/Curation">000077</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000077</idno><idno type="wicri:Area/Main/Exploration">000077</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">[Impact of guideline adherence on mortality in treatment of left heart failure].</title><author><name sortKey="Neubauer, S" sort="Neubauer, S" uniqKey="Neubauer S" first="S" last="Neubauer">S. Neubauer</name><affiliation wicri:level="3"><nlm:affiliation>Leibniz Universität Hannover, Center for Health Economics Research Hannover (CHERH), Hannover, Deutschland. sn@cherh.de.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Leibniz Universität Hannover, Center for Health Economics Research Hannover (CHERH), Hannover</wicri:regionArea><placeName><region type="land" nuts="2">Basse-Saxe</region><settlement type="city">Hanovre</settlement></placeName></affiliation></author><author><name sortKey="Schilling, T" sort="Schilling, T" uniqKey="Schilling T" first="T" last="Schilling">T. Schilling</name><affiliation wicri:level="3"><nlm:affiliation>Medizinische Hochschule Hannover, Klinik für Herz-, Thorax-, Transplantations- und Gefäßchirurgie (HTTG), Hannover, Deutschland.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Medizinische Hochschule Hannover, Klinik für Herz-, Thorax-, Transplantations- und Gefäßchirurgie (HTTG), Hannover</wicri:regionArea><placeName><region type="land" nuts="2">Basse-Saxe</region><settlement type="city">Hanovre</settlement></placeName></affiliation></author><author><name sortKey="Zeidler, J" sort="Zeidler, J" uniqKey="Zeidler J" first="J" last="Zeidler">J. Zeidler</name><affiliation wicri:level="3"><nlm:affiliation>Leibniz Universität Hannover, Center for Health Economics Research Hannover (CHERH), Hannover, Deutschland.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Leibniz Universität Hannover, Center for Health Economics Research Hannover (CHERH), Hannover</wicri:regionArea><placeName><region type="land" nuts="2">Basse-Saxe</region><settlement type="city">Hanovre</settlement></placeName></affiliation></author><author><name sortKey="Lange, A" sort="Lange, A" uniqKey="Lange A" first="A" last="Lange">A. Lange</name><affiliation wicri:level="3"><nlm:affiliation>Leibniz Universität Hannover, Center for Health Economics Research Hannover (CHERH), Hannover, Deutschland.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Leibniz Universität Hannover, Center for Health Economics Research Hannover (CHERH), Hannover</wicri:regionArea><placeName><region type="land" nuts="2">Basse-Saxe</region><settlement type="city">Hanovre</settlement></placeName></affiliation></author><author><name sortKey="Engel, S" sort="Engel, S" uniqKey="Engel S" first="S" last="Engel">S. Engel</name><affiliation wicri:level="3"><nlm:affiliation>Techniker Krankenkasse, Wissenschaftliches Institut für Nutzen und Effizienz im Gesundheitswesen (WINEG), Hamburg, Deutschland.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Techniker Krankenkasse, Wissenschaftliches Institut für Nutzen und Effizienz im Gesundheitswesen (WINEG), Hamburg</wicri:regionArea><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation></author><author><name sortKey="Linder, R" sort="Linder, R" uniqKey="Linder R" first="R" last="Linder">R. Linder</name><affiliation wicri:level="3"><nlm:affiliation>Techniker Krankenkasse, Wissenschaftliches Institut für Nutzen und Effizienz im Gesundheitswesen (WINEG), Hamburg, Deutschland.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Techniker Krankenkasse, Wissenschaftliches Institut für Nutzen und Effizienz im Gesundheitswesen (WINEG), Hamburg</wicri:regionArea><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation></author><author><name sortKey="Verheyen, F" sort="Verheyen, F" uniqKey="Verheyen F" first="F" last="Verheyen">F. Verheyen</name><affiliation wicri:level="3"><nlm:affiliation>Techniker Krankenkasse, Wissenschaftliches Institut für Nutzen und Effizienz im Gesundheitswesen (WINEG), Hamburg, Deutschland.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Techniker Krankenkasse, Wissenschaftliches Institut für Nutzen und Effizienz im Gesundheitswesen (WINEG), Hamburg</wicri:regionArea><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation></author><author><name sortKey="Von Der Schulenburg, J M Graf" sort="Von Der Schulenburg, J M Graf" uniqKey="Von Der Schulenburg J" first="J-M Graf" last="Von Der Schulenburg">J-M Graf Von Der Schulenburg</name><affiliation wicri:level="3"><nlm:affiliation>Leibniz Universität Hannover, Center for Health Economics Research Hannover (CHERH), Hannover, Deutschland.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Leibniz Universität Hannover, Center for Health Economics Research Hannover (CHERH), Hannover</wicri:regionArea><placeName><region type="land" nuts="2">Basse-Saxe</region><settlement type="city">Hanovre</settlement></placeName></affiliation></author><author><name sortKey="Haverich, A" sort="Haverich, A" uniqKey="Haverich A" first="A" last="Haverich">A. Haverich</name><affiliation wicri:level="3"><nlm:affiliation>Medizinische Hochschule Hannover, Klinik für Herz-, Thorax-, Transplantations- und Gefäßchirurgie (HTTG), Hannover, Deutschland.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Medizinische Hochschule Hannover, Klinik für Herz-, Thorax-, Transplantations- und Gefäßchirurgie (HTTG), Hannover</wicri:regionArea><placeName><region type="land" nuts="2">Basse-Saxe</region><settlement type="city">Hanovre</settlement></placeName></affiliation></author></analytic><series><title level="j">Herz</title><idno type="eISSN">1615-6692</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Age Distribution (MeSH)</term><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Cardiology (standards)</term><term>Cardiotonic Agents (standards)</term><term>Cardiotonic Agents (therapeutic use)</term><term>Echocardiography (standards)</term><term>Echocardiography (statistics & numerical data)</term><term>Female (MeSH)</term><term>Germany (epidemiology)</term><term>Guideline Adherence (standards)</term><term>Guideline Adherence (statistics & numerical data)</term><term>Heart Failure (diagnosis)</term><term>Heart Failure (mortality)</term><term>Heart Failure (therapy)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Practice Guidelines as Topic (MeSH)</term><term>Prevalence (MeSH)</term><term>Risk Factors (MeSH)</term><term>Sex Distribution (MeSH)</term><term>Survival Rate (MeSH)</term><term>Treatment Outcome (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adhésion aux directives (normes)</term><term>Adhésion aux directives (statistiques et données numériques)</term><term>Adulte d'âge moyen (MeSH)</term><term>Allemagne (épidémiologie)</term><term>Cardiologie (normes)</term><term>Cardiotoniques (normes)</term><term>Cardiotoniques (usage thérapeutique)</term><term>Défaillance cardiaque (diagnostic)</term><term>Défaillance cardiaque (mortalité)</term><term>Défaillance cardiaque (thérapie)</term><term>Facteurs de risque (MeSH)</term><term>Femelle (MeSH)</term><term>Guides de bonnes pratiques cliniques comme sujet (MeSH)</term><term>Humains (MeSH)</term><term>Mâle (MeSH)</term><term>Prévalence (MeSH)</term><term>Répartition par sexe (MeSH)</term><term>Répartition par âge (MeSH)</term><term>Résultat thérapeutique (MeSH)</term><term>Sujet âgé (MeSH)</term><term>Sujet âgé de 80 ans ou plus (MeSH)</term><term>Taux de survie (MeSH)</term><term>Échocardiographie (normes)</term><term>Échocardiographie (statistiques et données numériques)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="standards" xml:lang="en"><term>Cardiotonic Agents</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Heart Failure</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Défaillance cardiaque</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Germany</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Heart Failure</term></keywords><keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Défaillance cardiaque</term></keywords><keywords scheme="MESH" qualifier="normes" xml:lang="fr"><term>Adhésion aux directives</term><term>Cardiologie</term><term>Cardiotoniques</term><term>Échocardiographie</term></keywords><keywords scheme="MESH" qualifier="standards" xml:lang="en"><term>Cardiology</term><term>Echocardiography</term><term>Guideline Adherence</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Echocardiography</term><term>Guideline Adherence</term></keywords><keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Adhésion aux directives</term><term>Échocardiographie</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Cardiotonic Agents</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Heart Failure</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Défaillance cardiaque</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Cardiotoniques</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Allemagne</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Age Distribution</term><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Practice Guidelines as Topic</term><term>Prevalence</term><term>Risk Factors</term><term>Sex Distribution</term><term>Survival Rate</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Facteurs de risque</term><term>Femelle</term><term>Guides de bonnes pratiques cliniques comme sujet</term><term>Humains</term><term>Mâle</term><term>Prévalence</term><term>Répartition par sexe</term><term>Répartition par âge</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Taux de survie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>The German national guidelines on chronic heart failure provide treatment recommendations to physicians and reflect the current level of evidence; however, it is questionable to what extent these recommendations are applied in the routine practice and what the effect of guideline adherence on mortality is.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>In this study the claims data of a major German health insurance fund collected over a period of 4 years were analyzed. Using binary logistic regression and Cox regression analyses the influence of drug prescriptions, diagnostic measures, influenza vaccination, the New York Heart Association (NYHA) status, the age and gender on mortality were examined.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>The study population consisted of 85,465 heart failure patients. Approximately 60 % of the drugs were prescribed according to the guidelines. There was a positive correlation between a higher NYHA status and mortality with an odds ratio (OR) of 3.264. Especially pharmacotherapy with angiotensin-converting enzyme (ACE) inhibitors and beta blockers according to the guidelines was associated with a lower mortality rate (OR 0.448 resp. 0.444). Also patients diagnosed using echocardiography at regular intervals showed a lower risk of dying (OR 0.314).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>The results of this large sample could confirm the results of clinical trials that a therapy according to the guidelines has a significant impact on mortality. By analyzing the claims data evidence was found that in the treatment of heart failure patients the medical results could be improved by adherence to guideline recommendations.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">26883900</PMID><DateCompleted><Year>2017</Year><Month>06</Month><Day>20</Day></DateCompleted><DateRevised><Year>2018</Year><Month>12</Month><Day>02</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1615-6692</ISSN><JournalIssue CitedMedium="Internet"><Volume>41</Volume><Issue>7</Issue><PubDate><Year>2016</Year><Month>Nov</Month></PubDate></JournalIssue><Title>Herz</Title><ISOAbbreviation>Herz</ISOAbbreviation></Journal><ArticleTitle>[Impact of guideline adherence on mortality in treatment of left heart failure].</ArticleTitle><Pagination><MedlinePgn>614-624</MedlinePgn></Pagination><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">The German national guidelines on chronic heart failure provide treatment recommendations to physicians and reflect the current level of evidence; however, it is questionable to what extent these recommendations are applied in the routine practice and what the effect of guideline adherence on mortality is.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">In this study the claims data of a major German health insurance fund collected over a period of 4 years were analyzed. Using binary logistic regression and Cox regression analyses the influence of drug prescriptions, diagnostic measures, influenza vaccination, the New York Heart Association (NYHA) status, the age and gender on mortality were examined.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">The study population consisted of 85,465 heart failure patients. Approximately 60 % of the drugs were prescribed according to the guidelines. There was a positive correlation between a higher NYHA status and mortality with an odds ratio (OR) of 3.264. Especially pharmacotherapy with angiotensin-converting enzyme (ACE) inhibitors and beta blockers according to the guidelines was associated with a lower mortality rate (OR 0.448 resp. 0.444). Also patients diagnosed using echocardiography at regular intervals showed a lower risk of dying (OR 0.314).</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">The results of this large sample could confirm the results of clinical trials that a therapy according to the guidelines has a significant impact on mortality. By analyzing the claims data evidence was found that in the treatment of heart failure patients the medical results could be improved by adherence to guideline recommendations.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Neubauer</LastName><ForeName>S</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Leibniz Universität Hannover, Center for Health Economics Research Hannover (CHERH), Hannover, Deutschland. sn@cherh.de.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schilling</LastName><ForeName>T</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Medizinische Hochschule Hannover, Klinik für Herz-, Thorax-, Transplantations- und Gefäßchirurgie (HTTG), Hannover, Deutschland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zeidler</LastName><ForeName>J</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Leibniz Universität Hannover, Center for Health Economics Research Hannover (CHERH), Hannover, Deutschland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lange</LastName><ForeName>A</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Leibniz Universität Hannover, Center for Health Economics Research Hannover (CHERH), Hannover, Deutschland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Engel</LastName><ForeName>S</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Techniker Krankenkasse, Wissenschaftliches Institut für Nutzen und Effizienz im Gesundheitswesen (WINEG), Hamburg, Deutschland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Linder</LastName><ForeName>R</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Techniker Krankenkasse, Wissenschaftliches Institut für Nutzen und Effizienz im Gesundheitswesen (WINEG), Hamburg, Deutschland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Verheyen</LastName><ForeName>F</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Techniker Krankenkasse, Wissenschaftliches Institut für Nutzen und Effizienz im Gesundheitswesen (WINEG), Hamburg, Deutschland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>von der Schulenburg</LastName><ForeName>J-M Graf</ForeName><Initials>JG</Initials><AffiliationInfo><Affiliation>Leibniz Universität Hannover, Center for Health Economics Research Hannover (CHERH), Hannover, Deutschland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Haverich</LastName><ForeName>A</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Medizinische Hochschule Hannover, Klinik für Herz-, Thorax-, Transplantations- und Gefäßchirurgie (HTTG), Hannover, Deutschland.</Affiliation></AffiliationInfo></Author></AuthorList><Language>ger</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><VernacularTitle>Auswirkung einer leitliniengerechten Behandlung auf die Mortalität bei Linksherzinsuffizienz.</VernacularTitle><ArticleDate DateType="Electronic"><Year>2016</Year><Month>02</Month><Day>16</Day></ArticleDate></Article><MedlineJournalInfo><Country>Germany</Country><MedlineTA>Herz</MedlineTA><NlmUniqueID>7801231</NlmUniqueID><ISSNLinking>0340-9937</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D002316">Cardiotonic Agents</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D017677" MajorTopicYN="N">Age Distribution</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002309" MajorTopicYN="N">Cardiology</DescriptorName><QualifierName UI="Q000592" MajorTopicYN="N">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002316" MajorTopicYN="N">Cardiotonic Agents</DescriptorName><QualifierName UI="Q000592" MajorTopicYN="N">standards</QualifierName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004452" MajorTopicYN="N">Echocardiography</DescriptorName><QualifierName UI="Q000592" MajorTopicYN="Y">standards</QualifierName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005858" MajorTopicYN="N">Germany</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D019983" MajorTopicYN="N">Guideline Adherence</DescriptorName><QualifierName UI="Q000592" MajorTopicYN="N">standards</QualifierName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006333" MajorTopicYN="N">Heart Failure</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000401" MajorTopicYN="Y">mortality</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017410" MajorTopicYN="Y">Practice Guidelines as Topic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015995" MajorTopicYN="N">Prevalence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017678" MajorTopicYN="N">Sex Distribution</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015996" MajorTopicYN="N">Survival Rate</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Claims data</Keyword><Keyword MajorTopicYN="N">Guideline adherence</Keyword><Keyword MajorTopicYN="N">Heart failure</Keyword><Keyword MajorTopicYN="N">Mortality</Keyword><Keyword MajorTopicYN="N">Pharmacotherapy</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2015</Year><Month>11</Month><Day>24</Day></PubMedPubDate><PubMedPubDate 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