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Socioeconomic Inequalities in the Prescription of Oral Anticoagulants in Stroke Patients With Atrial Fibrillation
Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap, Farmakologi. Umeå universitet, Samhällsvetenskapliga fakulteten, Handelshögskolan vid Umeå universitet, Statistik.ORCID-id: 0000-0002-8364-6290
Umeå universitet, Samhällsvetenskapliga fakulteten, Handelshögskolan vid Umeå universitet, Statistik.ORCID-id: 0000-0003-3298-1555
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
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2015 (Engelska)Ingår i: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 46, nr 8, s. 2220-2225Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background and Purpose—Oral anticoagulants (OACs) are effective against ischemic stroke in patients with atrial fibrillation. Our aim was to investigate differences in the prescribing of OACs after ischemic stroke in patients with atrial fibrillation based on age, sex, country of birth, and socioeconomic status.

Methods—Patients with first-ever ischemic stroke and atrial fibrillation without OAC treatment were included from the Swedish stroke register from 2009 to 2012. The outcome was OAC prescribed at discharge. Income, education, country of birth, and risk factors were obtained from official registers. Risk factors and health status were controlled for in multivariable logistic regression.

Results—Of 12 088 stroke patients, 36.3% were prescribed an OAC. Prescribing was less common with older age and, in patients born in other Nordic countries (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.68–0.98) or countries outside of Europe (OR, 0.65; 95% CI, 0.42–0.99) compared with those born in Sweden. University education (OR, 1.20; 95% CI, 1.05–1.36) and highest income (OR, 1.19; 95% CI, 1.06–1.33) were associated with higher levels of OAC prescribing compared with those with primary school education or lowest income level.

Conclusion—Differences by age, income, education, and country of birth were found in the prescribing of OACs after stroke. Differences were not explained by common risk factors. This indicates socioeconomic inequalities in the prescribing of preventive treatment after stroke.

Ort, förlag, år, upplaga, sidor
2015. Vol. 46, nr 8, s. 2220-2225
Nationell ämneskategori
Klinisk medicin
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URN: urn:nbn:se:umu:diva-105102DOI: 10.1161/STROKEAHA.115.009718ISI: 000359972200045OAI: oai:DiVA.org:umu-105102DiVA, id: diva2:823310
Tillgänglig från: 2015-06-18 Skapad: 2015-06-18 Senast uppdaterad: 2018-06-07Bibliografiskt granskad

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Sjölander, MariaEriksson, MarieAsplund, KjellGlader, Eva-Lotta

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