PT - JOURNAL ARTICLE AU - Sunil M Shah AU - Iain M Carey AU - Stephen DeWilde AU - Nicky Richards AU - Derek G Cook TI - Trends and inequities in beta-blocker prescribing for heart failure AID - 10.3399/bjgp08X376195 DP - 2008 Dec 01 TA - British Journal of General Practice PG - 862--869 VI - 58 IP - 557 4099 - http://bjgp.org/content/58/557/862.short 4100 - http://bjgp.org/content/58/557/862.full SO - Br J Gen Pract2008 Dec 01; 58 AB - Background Treatment with specific beta-blockers reduces mortality and hospitalisation in heart failure.Aim To describe trends and inequities in beta-blocker prescribing for heart failure.Design of study Repeated cross-sectional analysis of a nationally representative primary care database (DIN-LINK).Setting A total of 152 UK general practices.Method Prescribing of beta-blockers between 2000 and 2005 was examined among a yearly average of 7294 patients aged ≥50 years who had actively managed heart failure — defined as a recorded diagnosis of heart failure and two prescriptions of an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker during the calendar year. The main outcome was the prescription of a guideline-recommended beta-blocker (bisoprolol, carvedilol, metoprolol, or nebivolol) in the year. Determinants of beta-blocker prescribing were analysed using logistic regression.Results Between 2000 and 2005, age-adjusted use of recommended beta-blockers rose from 6.1% to 27.0% in men, and from 4.2% to 21.5% in women. In 2005, younger patients were more likely to be treated; the fully adjusted odds ratio was 4.83 (95% confidence interval = 3.78 to 6.17) for patients aged 60–64 years compared with those aged 85 years. Women and patients living in areas of socioeconomic deprivation were less likely to be treated. In 2005, in addition to treatment with guideline-recommended beta-blockers, a further 11.7% of men and 12.5% of women were prescribed other beta-blockers.Conclusion Recommended beta-blocker use has risen in the UK but remains low and inequitable, with many patients still treated with beta-blockers that are not recommended in guidelines. This suggests further improvements in prescribing are still possible.