Background: Beta blocker (BB) doses are often suboptimal in\nheart failure (HF) management. Differences in BB management\npatterns may exist between physicians in family medicine (FM) and\ninternal medicine (IM). The aims of this study were to compare: 1)\nBB doses and prescription patterns; and 2) health care utilization\nrates in patients cared for by all primary care physicians compared\nto an historical control group after an educational program on HF\nmanagement. A subgroup analysis was performed between patients\ncared for by FM and IM physicians. A secondary aim was to assess\nphysician knowledge scores and satisfaction.\nMethods: A historically controlled study was conducted among\nlow-income, underserved HF patients (mean age 54.1 �± 13.1, males\n70%, mean ejection fraction 28.2 �± 9.8%). Statistical methods included\nlinear mixed models and Fisherâ��s exact tests to assess prescription\npatterns of BB dosing and health care utilization rates (all\ncause and HF related hospitalizations, emergency department use\nand clinic visits).\nResults: Among 135 patients (experimental N = 81 and control N =\n54), a linear mixed model test of group by time interaction showed\nno difference in BB dosage (t = -0.12, P = 0.91). FM physicians\nprescribed significant changes in BB doses compared to IM physicians\n(P = 0.04), had higher numbers of clinic visits (P = 0.03) and\nreported greater satisfaction with the program.\nConclusions: There was no difference in BB titration rates following\nan HF training intervention for physicians compared to historical\ncontrols. However, FM physicians had a greater change in\nprescribing practices compared to IM physicians. Educational programs\ntargeting FM physicians may benefit HF patients and could\npotentially lead to greater adherence to clinical guidelines related to\nBB use and address gaps in providing HF care.
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