Persistence of Beta-Blocker Treatment after a Heart Attack (PBH)

The HEDIS measure addresses the appropriate clinical management of a person who has experienced an acute myocardial infarction (AMI).  Persistent beta-blocker treatment after a heart attack reduces the risk of mortality, as well as the risk and severity of reinfarction and improves the preservation of the left ventricular function.

Every 34 seconds, someone in the United States has a heart attack.  A heart attack, or myocardial infarction, occurs when blood flow to the heart is greatly reduced or stops completely.  Clinical guidelines recommend taking a beta-blocker after a heart attack to prevent another heart attack from occurring.  Beta-blockers work by lowering the heart rate.  This reduces the amount of force on the heart and blood vessels. Persistent use of a beta-blocker after a heart attack can improve survival and heart disease outcomes. (NCQA.org)

The measure assesses the percentage of adults 18 years of age and older during the measurement year who were hospitalized and discharged alive with a diagnosis of acute myocardial infarction and who received persistent beta-blocker treatment for 180 days post discharge for AMI.

Beta-blockers have been regularly used after acute myocardial infarction (AMI) as part of routine therapy and in secondary prevention.  Recommendations continue to support the use of beta-blockers, although it is inconclusive whether the prolonged use beyond one-year post-AMI is essential, particularly for low-risk patients.

Persistence of beta-blocker treatment for this measure is defined as medication dispensed for at least 135 days in the 180-day interval.  Patients identified as having intolerance or allergy to beta-blocker therapy are excluded from the measurement.  This includes conditions such as:  asthma, COPD, hypotension, heart block >1 degree or sinus bradycardia.

Beta-Blocker Medications

References

Cardiology, *D. of. (n.d.). Long-term beta-blocker therapy after myocardial infarction... : Journal of Cardiovascular Pharmacology. LWW. Retrieved September 8, 2022, from https://journals.lww.com/cardiovascularpharm/Abstract/2022/05000/Long_Term_Beta_Blocker_Therapy_After_Myocardial.8.aspx

Desta, L., Desta, L. D. L., Raposeiras-Roubin, S., Sergio Raposeiras-Roubin https://orcid.org/0000-0002-6462-4715 Clinical Research Department, Ibanez, B., Borja Ibanez Correspondence to: Borja Ibanez, The opinions expressed in this article are not necessarily those of the editors or of the American Heart Association.For Sources of Funding and Disclosures, Al., E., & Park, C. S. (2021, April 20). The art of prescribing β-blockers after myocardial infarction. Circulation: Cardiovascular Interventions. Retrieved September 8, 2022, from https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.121.010720

Lee, S.-J., Choi, D.-W., Kim, C., Suh, Y., Hong, S.-J., Ahn, C.-M., Kim, J.-S., Kim, B.-K., Ko, Y.-G., Choi, D., Park, E.-C., Jang, Y., Nam, C.-M., & Hong, M.-K. (1AD, January 1). Long-term beta-blocker therapy in patients with stable coronary artery disease after percutaneous coronary intervention. Frontiers. Retrieved September 8, 2022, from https://www.frontiersin.org/articles/10.3389/fcvm.2022.878003/full

O'Neill, A. (2020, December 20). Persistence of beta-blocker treatment after a heart attack. NCQA. Retrieved September 8, 2022, from https://www.ncqa.org/hedis/measures/persistence-of-beta-blocker-treatment-after-a-heart-attack