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Socioeconomic Inequalities in the Prescription of Oral Anticoagulants in Stroke Patients With Atrial Fibrillation
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology. Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.ORCID iD: 0000-0002-8364-6290
Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.ORCID iD: 0000-0003-3298-1555
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
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2015 (English)In: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 46, no 8, 2220-2225 p.Article in journal (Refereed) 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.

Place, publisher, year, edition, pages
2015. Vol. 46, no 8, 2220-2225 p.
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:umu:diva-105102DOI: 10.1161/STROKEAHA.115.009718ISI: 000359972200045OAI: oai:DiVA.org:umu-105102DiVA: diva2:823310
Available from: 2015-06-18 Created: 2015-06-18 Last updated: 2017-12-04Bibliographically approved

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