Are doctors using more preventive medication for cardiovascular disease? A Swedish cross-sectional study
AbstractBackground Despite decreasing mortality from cardiovascular disease (CVD), there are persistent inequities in mortality between socioeconomic groups. Primary preventative medications reduce mortality in CVD; thus, inequitable treatments will contribute to unequal outcomes. Physicians might c...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-07-01
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| Series: | Scandinavian Journal of Primary Health Care |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/02813432.2023.2234439 |
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| author | Joel Lillqvist Johan N. Sommar Per E. Gustafsson Eva-Lotta Glader Katarina Hamberg Olov Rolandsson |
| author_facet | Joel Lillqvist Johan N. Sommar Per E. Gustafsson Eva-Lotta Glader Katarina Hamberg Olov Rolandsson |
| author_sort | Joel Lillqvist |
| collection | DOAJ |
| description | AbstractBackground Despite decreasing mortality from cardiovascular disease (CVD), there are persistent inequities in mortality between socioeconomic groups. Primary preventative medications reduce mortality in CVD; thus, inequitable treatments will contribute to unequal outcomes. Physicians might contribute to inequality by prescribing preventative medication for CVD to themselves in a biased manner.Aim To determine whether primary medications for preventing CVD were prescribed inequitably between physicians and non-physicians.Design and setting This retrospective study retrieved registry data on prescribed medications for all physicians in Sweden aged 45–74 years, during 2013, and for reference non-physician individuals, matched by sex, age, residence, and level of education. The outcome was any medication for preventing CVD, received at least once during 2013.Method Age and the sex-specific prevalence of myocardial infarction (MI) among physicians and non-physicians were used as a proxy for the need for medication. Thereafter, to limit the analysis to preventative medication, we excluded individuals that were diagnosed with CVD or diabetes. To analyse differences in medication usage between physicians and matched non-physicians, we estimated odds ratios (ORs) with conditional logistic regression and adjusted for need and household income.Results MI prevalences were 5.7% for men and 2.3% for women, among physicians, and 5.4% for men and 1.8% for women, among non-physicians. We included 25,105 physicians and 44,366 non-physicians. The OR for physicians receiving any CVD preventative medication, compared to non-physicians, was 1.65 (95% confidence interval 1.59–1.72).Conclusion We found an inequity in prescribed preventative CVD medications, which favoured physicians over non-physicians. |
| first_indexed | 2024-03-12T11:25:24Z |
| format | Article |
| id | doaj.art-bcc88d725a984be4968e01f5fd5931ab |
| institution | Directory Open Access Journal |
| issn | 0281-3432 1502-7724 |
| language | English |
| last_indexed | 2024-03-12T11:25:24Z |
| publishDate | 2023-07-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Scandinavian Journal of Primary Health Care |
| spelling | doaj.art-bcc88d725a984be4968e01f5fd5931ab2023-09-01T09:47:49ZengTaylor & Francis GroupScandinavian Journal of Primary Health Care0281-34321502-77242023-07-0141329730510.1080/02813432.2023.2234439Are doctors using more preventive medication for cardiovascular disease? A Swedish cross-sectional studyJoel Lillqvist0Johan N. Sommar1Per E. Gustafsson2Eva-Lotta Glader3Katarina Hamberg4Olov Rolandsson5Department of Public Health and Clinical Medicine, Umeå University, Umea, SwedenDepartment of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umea, SwedenDepartment of Epidemiology and Global Health, Umeå University, Umea, SwedenDepartment of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umea, SwedenDepartment of Public Health and Clinical Medicine, Umeå University, Umea, SwedenDepartment of Public Health and Clinical Medicine, Umeå University, Umea, SwedenAbstractBackground Despite decreasing mortality from cardiovascular disease (CVD), there are persistent inequities in mortality between socioeconomic groups. Primary preventative medications reduce mortality in CVD; thus, inequitable treatments will contribute to unequal outcomes. Physicians might contribute to inequality by prescribing preventative medication for CVD to themselves in a biased manner.Aim To determine whether primary medications for preventing CVD were prescribed inequitably between physicians and non-physicians.Design and setting This retrospective study retrieved registry data on prescribed medications for all physicians in Sweden aged 45–74 years, during 2013, and for reference non-physician individuals, matched by sex, age, residence, and level of education. The outcome was any medication for preventing CVD, received at least once during 2013.Method Age and the sex-specific prevalence of myocardial infarction (MI) among physicians and non-physicians were used as a proxy for the need for medication. Thereafter, to limit the analysis to preventative medication, we excluded individuals that were diagnosed with CVD or diabetes. To analyse differences in medication usage between physicians and matched non-physicians, we estimated odds ratios (ORs) with conditional logistic regression and adjusted for need and household income.Results MI prevalences were 5.7% for men and 2.3% for women, among physicians, and 5.4% for men and 1.8% for women, among non-physicians. We included 25,105 physicians and 44,366 non-physicians. The OR for physicians receiving any CVD preventative medication, compared to non-physicians, was 1.65 (95% confidence interval 1.59–1.72).Conclusion We found an inequity in prescribed preventative CVD medications, which favoured physicians over non-physicians.https://www.tandfonline.com/doi/10.1080/02813432.2023.2234439Healthcare inequitiespharmacoepidemiologycardiovascular diseasepreventionepidemiology |
| spellingShingle | Joel Lillqvist Johan N. Sommar Per E. Gustafsson Eva-Lotta Glader Katarina Hamberg Olov Rolandsson Are doctors using more preventive medication for cardiovascular disease? A Swedish cross-sectional study Scandinavian Journal of Primary Health Care Healthcare inequities pharmacoepidemiology cardiovascular disease prevention epidemiology |
| title | Are doctors using more preventive medication for cardiovascular disease? A Swedish cross-sectional study |
| title_full | Are doctors using more preventive medication for cardiovascular disease? A Swedish cross-sectional study |
| title_fullStr | Are doctors using more preventive medication for cardiovascular disease? A Swedish cross-sectional study |
| title_full_unstemmed | Are doctors using more preventive medication for cardiovascular disease? A Swedish cross-sectional study |
| title_short | Are doctors using more preventive medication for cardiovascular disease? A Swedish cross-sectional study |
| title_sort | are doctors using more preventive medication for cardiovascular disease a swedish cross sectional study |
| topic | Healthcare inequities pharmacoepidemiology cardiovascular disease prevention epidemiology |
| url | https://www.tandfonline.com/doi/10.1080/02813432.2023.2234439 |
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