TY - JOUR
T1 - Long-term beta blocker prescribing after myocardial infarction in European primary care (PRACTITIONER)
AU - Zangger, Martina
AU - Jungo, Katharina Tabea
AU - Adler, Limor
AU - Assenova, Radost
AU - Batic-Mujanovic, Olivera
AU - Bracchitta, Luigi
AU - Brütting, Christine
AU - Buczkowski, Krzysztof
AU - Danilenko, Jelena
AU - Erber, Patrick
AU - Gefaell Larrondo, Ileana
AU - Ilkov, Oksana
AU - Javorska, Katerina
AU - Jennings, Aisling A.
AU - Johannessen, Tonje R.
AU - Koskela, Tuomas
AU - Kurpas, Donata
AU - Lazić, Vanja
AU - Mannheimer, Stina
AU - Moussa, Mahmoud
AU - Seifert, Martin
AU - Taraj, Deona
AU - Torzsa, Peter
AU - Viegas Dias, Catarina
AU - Zelko, Erika
AU - Gencer, Baris
AU - Streit, Sven
PY - 2026/2/9
Y1 - 2026/2/9
N2 - Background: The long-term use of beta blockers after myocardial infarction in patients with preserved ventricular function is debated. General practitioners (GPs) often decide whether to continue or discontinue long-term medications, yet little is known about how they apply evolving evidence to clinical prescribing decisions. Objective: To assess whether GPs are willing to deprescribe beta blockers post myocardial infarction with preserved left ventricular function and to identify factors associated with deprescribing decisions. Design: Cross-sectional online survey using case vignettes, conducted between July 2023 and October 2024 in primary care settings in 24 sites across 20 European countries. Participants: Practicing GPs recruited through convenience sampling at each site. Main measures: The primary outcome was whether the GP chose to deprescribe beta blockers in the vignettes. Adjusted risk ratios for the association between GP characteristics and the decision to deprescribe were estimated using Poisson regression with generalized estimating equations and robust standard errors, accounting for clustering at the GP and country level. Key results: 604 GPs participated in the survey (median [IQR] age, 44.0 [35.0-54.8] years; 364 [60.3%] female), 89.2% deprescribed beta blockers in at least one vignette. The likelihood of deprescribing increased with time since myocardial infarction (adjusted risk ratio [RR] = 1.28; 95% CI 1.21–1.36 after 5 years; RR = 1.78; 95% CI 1.66–1.90 after 10 years vs. 3 months) and with side effects (RR = 1.76; 95% CI 1.66–1.88). More years of clinical experience were associated with a lower likelihood of deprescribing (RR = 0.86; 95% CI 0.77–0.95 for most vs. least experienced). Conclusions: In this cross-national vignette study, most GPs were willing to deprescribe beta blockers after myocardial infarction in patients with preserved left ventricular function, particularly when time had passed and side effects were present. These findings suggest that GPs are open to applying evolving evidence on beta blocker discontinuation in clinical care.
AB - Background: The long-term use of beta blockers after myocardial infarction in patients with preserved ventricular function is debated. General practitioners (GPs) often decide whether to continue or discontinue long-term medications, yet little is known about how they apply evolving evidence to clinical prescribing decisions. Objective: To assess whether GPs are willing to deprescribe beta blockers post myocardial infarction with preserved left ventricular function and to identify factors associated with deprescribing decisions. Design: Cross-sectional online survey using case vignettes, conducted between July 2023 and October 2024 in primary care settings in 24 sites across 20 European countries. Participants: Practicing GPs recruited through convenience sampling at each site. Main measures: The primary outcome was whether the GP chose to deprescribe beta blockers in the vignettes. Adjusted risk ratios for the association between GP characteristics and the decision to deprescribe were estimated using Poisson regression with generalized estimating equations and robust standard errors, accounting for clustering at the GP and country level. Key results: 604 GPs participated in the survey (median [IQR] age, 44.0 [35.0-54.8] years; 364 [60.3%] female), 89.2% deprescribed beta blockers in at least one vignette. The likelihood of deprescribing increased with time since myocardial infarction (adjusted risk ratio [RR] = 1.28; 95% CI 1.21–1.36 after 5 years; RR = 1.78; 95% CI 1.66–1.90 after 10 years vs. 3 months) and with side effects (RR = 1.76; 95% CI 1.66–1.88). More years of clinical experience were associated with a lower likelihood of deprescribing (RR = 0.86; 95% CI 0.77–0.95 for most vs. least experienced). Conclusions: In this cross-national vignette study, most GPs were willing to deprescribe beta blockers after myocardial infarction in patients with preserved left ventricular function, particularly when time had passed and side effects were present. These findings suggest that GPs are open to applying evolving evidence on beta blocker discontinuation in clinical care.
KW - Beta blocker
KW - Deprescribing
KW - Myocardial infarction
KW - Preserved left ventricular function
KW - Primary care
UR - https://www.scopus.com/pages/publications/105033510776
U2 - 10.1186/s12875-026-03208-6
DO - 10.1186/s12875-026-03208-6
M3 - Article
C2 - 41663967
AN - SCOPUS:105033510776
SN - 2731-4553
VL - 27
JO - BMC Primary Care
JF - BMC Primary Care
IS - 1
M1 - 93
ER -