OBJECTIVES : The role of general physicians in managing Congestive Heart Failure (CHF) has been important to reduce mortality and hospitalizations, particularly in stable patients, as these patients drive the majority of CHF-related morbidity and mortality^1,2. CHF treatment is often initiated by cardiologists with routine follow-up done by general physicians, indicating a possible gap in disease management between physician specialties. This research explores prescribing pattern between cardiologists and general physicians in the United States (US) and European CHF populations. Factors impacting physician’s prescribing tendency are also assessed to inform ways of improving CHF management by non-cardiologists.

METHODS : Analysis was conducted in EMR datasets for the US and 2 European countries. All data sets were converted into the OMOP Common Data Model, v5 and analyses were conducted in SHYFT Quantum v6.7.0. Using ACC/AHA/HFSA 2017 guidelines, prescribing pattern was evaluated for each drug class and compared between cardiologists and general physicians ³. Prescribing propensity was calculated for top treatment per drug class and compared across specialties. Factors driving prescribing tendency were examined using multivariate analysis and compared between US and European populations.

RESULTS : Cardiologists showed earlier time-to-prescription compared to general physicians. This result was consistent when looking at propensity distribution score for top treatments. Some variations on impact of patient demographics and comorbidities over physician’s prescribing tendency were observed between US and European populations.

CONCLUSIONS : Cardiologists continue to be the primary prescribers of CHF treatments in both US and Europe. Understanding the role of patient demographics and comorbidities on differences between US and European patients may be useful understanding patient-level factors influencing prescribing behavior. Future applications may help empower general physicians to initiate CHF treatment and increase collaboration with cardiologists to enhance patient outcomes.