JMIR Publications

ABSTRACT

Background:

Despite the exponential growth in telemedicine visits in clinical practice due to the COVID-19 pandemic, it remains unknown if telemedicine visits achieved similar adherence to guideline directed medical therapy (GDMT) as in-person office visits for patients with heart failure.

Objective:

Our study aimed to examine the association between type of visits and medication adherence to heart failure GDMT.

Methods:

This was a retrospective cross-sectional study of adult patients with a diagnosis of heart failure or ejection fraction ≤40% using the data between 4/1/2020 and 10/1/2020. Medication adherence was measured by the mean proportion of days covered (PDC) within 180 days, and categorized as adherence ifs PDC≥ 80%. Patients were included in the telemedicine exposure group if all encounters were video visits, and the in-person group if all encounters were in-person office visits. Poisson regression and logistic regression models were used for the analyses.

Results:

Total of 9,521 individuals were included in this analysis (830 individuals with telemedicine visits only and 8,691 in-person office visits only). There was no significant difference in mean PDC between telemedicine visit and in-person office visit groups (0.794 ± 0.294 vs. 0.812 ± 0.285)with the Rate Ratio [95% CI] of 0.99 [0.96, 1.02], p=0.086. Similarly, there was no significant difference in adherence rates between telemedicine visits and in-person office visit groups (69.0%vs.71.6%), with the Odds Ratio [95% CI] of 0.94 [0.81, 1.11], p=0.123.

Conclusions:

We found similar rates of medication adherence among patients with heart failure who were being seen via telemedicine and in-person.