Heart failure: beta blockers
Indicator
The percentage of patients with a current diagnosis of heart failure due to left ventricular systolic dysfunction, who are currently treated with a beta-blocker licensed for heart failure.
Indicator type
General practice indicator suitable for use in the Quality and Outcomes Framework.
This document does not represent formal NICE guidance. For a full list of NICE indicators, see our menu of indicators.
To find out how to use indicators and how we develop them, see our NICE indicator process guide.
Rationale
This indicator measures the percentage of people with heart failure due to left ventricular systolic dysfunction who are currently treated with beta-blockers.
The aim of treatment with beta-blockers is to reduce morbidity, hospitalisation and mortality in people with heart failure due to left ventricular systolic dysfunction. NICE's guidance on chronic heart failure recommends beta-blockers as treatment for all people with heart failure with reduced ejection fraction (HFREF), including older adults and people with defined comorbidities such as peripheral vascular disease, erectile dysfunction, diabetes mellitus, interstitial pulmonary disease and chronic obstructive pulmonary disease without reversibility.
The indicator refers to left ventricular systolic dysfunction (LVSD) rather than HFREF because it is the term historically used in GP practice. However, it is recommended for the ejection fraction to be recorded and for the ACE inhibitor or ARB to be prescribed to patients with HFREF below 40% in line with the guideline.
Source guidance
Chronic heart failure in adults: diagnosis and management. NICE guideline NG106 (2018), recommendations 1.4.1 and 1.4.7
Specification
Numerator: The number of patients in the denominator who are currently treated with a beta-blocker.
Denominator: The number of patients with a current diagnosis heart failure due to left ventricular systolic dysfunction or heart failure with reduced ejection fraction.
Calculation: Numerator divided by the denominator, multiplied by 100.
Exclusions:
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patients who were treated with an unlicensed beta-blocker in the period from 186 days before the patient's heart failure diagnosis up to and including the achievement date
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patients who have a persisting or expiring contraindication to licensed beta-blockers recorded or who chose not to receive beta blockers.
Minimum population: The indicator would be appropriate to assess performance at individual general practice level.
ISBN: 978-1-4731-5968-6