Disparities in the Prescription of Statins in the Primary Care Setting: A Retrospective Observational Study |
| |
| Affiliation: | 1. Heart and Vascular Center, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH;2. Faculty of Medicine, Hashemite University, Amman, Jordan;3. Department of Internal Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH;4. Department of Medicine, Allegheny Health Network, Pittsburgh, PA;5. Division of Hospital Medicine, University of Kentucky, Lexington, KY;6. Department of Cardiovascular Medicine, University of Iowa, IA;7. Department of Medicine, Cleveland Clinic Akron General, OH;8. Cleveland Clinic Foundation, OH;9. Center for Clinical Informatics, Division of Pulmonary Critical Care and Sleep Medicine, The MetroHealth System, OH;10. Department of Medicine, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH;1. Department of cardiology, University of Connecticut, Farmington, CT;2. Department of Internal Medicine, Islamic Hospital, Amman, Jordan;3. Department of Medicine, Alabama College of Osteopathic Medicine, Dothan, Alabama;4. Departments of Medicine, Cook County Hospital, Chicago, IL;5. Department of Internal Medicine, University of Kentucky, Lexington, KY;6. Department of Internal Medicine, University of Toledo, Toledo, OH;7. Department of Health Administration, Western Connecticut State University, CT;1. Department of Cardiology, Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina;2. Department of Emergency, Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina;3. Division of Cardiology, KHSC, Queen''s University, Kingston, Ontario, Canada;1. Department of Internal Medicine, Rochester General Hospital, Rochester, NY;2. Department of Cardiology, Mayo Clinic Arizona, Phoenix, AZ;3. Department of Cardiovascular Medicine, Mayo Clinic Rochester, Rochester, MN;4. Sands-Constellation Heart Institute, Rochester Regional Health, Rochester, NY;5. Division of Cardiology, Department of Medicine, Weill Cornell Medicine, New York, NY;1. Department of Medicine, Cleveland Clinic, Cleveland, OH;2. Department of Medicine, Forrest General Hospital, Hattiesburg, MS;3. Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX;4. Division of Cardiology, Lahey Hospital, and Medical Center, Beth Israel Lahey Health, Burlington, MA;5. Division of Health Equity & Disparities Research, Center for Outcomes Research, Houston Methodist, Houston, TX;6. Cardiovascular Division, Brigham and Women''s Hospital, Boston, MA;7. Center for Computational Health & Precision Medicine (C3-PH), Houston Methodist, Houston, TX;8. Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX;1. Division of Cardiovascular Diseases, Creighton University School of Medicine, Omaha, NE, USA;2. Department of Internal Medicine, McLaren Health Care/Michigan State University, Flint, MI, USA;3. Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington DC, USA;4. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA;5. Dell Medical School, University of Texas at Austin, Austin, TX, USA;6. Department of Clinical Medical Education, University of Tennessee at Nashville, Nashville, TN, USA;7. Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE, USA;8. Ascension Healthcare Cardiovascular Service Line;1. University of Texas Medical Branch, Department of Internal Medicine, Galveston, TX;2. University of Texas Medical Branch, Department of Internal Medicine, Division of Cardiovascular Diseases, Galveston, TX;3. Heart and Vascular Center, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH;4. Creighton University, Department of Internal Medicine, Omaha, NE |
| |
| Abstract: | Despite the high disease burden of atherosclerosis, evidence exists for the disparity in the prescription of guideline-indicated medications between genders, racial groups, socioeconomic groups, and ages. We aim to perform a retrospective study looking at the disparity in statin prescription for primary and secondary prevention in these groups. Data were collected from a single center and included patients with an LDL level >190 mg/dL, diagnosis of diabetes mellitus with LDL level >70 mg/dL, and diagnosis of cardiovascular disease regardless of LDL level. Patients older than 75 or younger than 21 were excluded from the study. Complex samples multivariable logistic and linear regression models were used to calculate the adjusted odds ratio and 95% confidence interval. The total study population was n = 56,995. Of those, 57.89% (n = 32,992) were female. Only 59.56 % of these patients for whom statin therapy was indicated received it. Most patients were White (53.21%) followed by African Americans (35.98%), Asians (2.43%), American Indian/Native Alaskans (0.40%), and Native Hawaiian/Pacific Islander (0.18%). There is a clear disparity in statin prescription favoring males, the elderly, and people of white ethnicity. Interestingly, Asians were more likely to be prescribed statins as opposed to whites. Self-pay patients were more likely to receive statins than patients on Medicare.Despite being indicated, Statins are under prescribed. Disparities based on race, gender, and insurance type mirror previous trends in the literature. Some results have shown a reversal in trends such as the higher prescription for Asian-Americans. Multiple patient-specific, provider-related, institutional factors might explain these disparities and must be investigated. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
