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Inequalities in medication adherence to statin treatment after stroke: A nationwide observational study
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.
2016 (English)In: European Stroke Journal, ISSN 2396-9873, Vol. 1, no 2, 101-107 p.Article in journal (Refereed) Published
Abstract [en]

Introduction: The objective was to investigate differences in adherence to statins after stroke based on age, sex, socioeconomic status and country of birth.

Patients and methods: Patients with ischemic stroke in 2009–2010 were included from the Swedish stroke register. Adherence to statin treatment was measured over two years as proportion of days covered with 80% as cut-off for adherence. Income, education, and country of birth were obtained from official registers. Factors associated with adherence were controlled for in multivariable logistic regression.

Results: Of 15,192 included patients, 73.9% had an adherence rate 80%. The oldest (85þ years) and youngest (18–54 years) had the lowest adherence, and a smaller proportion of women were adherent (odds ratio (OR) 0.84; 95% confidence interval (CI) 0.77–0.92). Adherence was less common in patients born in Nordic countries (OR 0.82; 95% CI (0.68–0.97), Europe (OR 0.78; 95% CI 0.65–0.93), and in non-European countries (OR 0.65; 95% CI 0.50–0.84) compared to Sweden-born. Patients with university education were to a lower extent adherent compared to patients with primary school education (OR 0.81; 95% CI 0.72–0.91). There was no association between adherence and income.

Discussion: The study was based on individual level real-life data with national coverage. Adherence was estimated from data on filled prescriptions, but filled prescription does not mean that drugs are used as intended.

Conclusion: Adherence to statin treatment over two years was suboptimal, and adherence was less common among women, patients born outside of Sweden and patients with university education.

Place, publisher, year, edition, pages
Sage Publications, 2016. Vol. 1, no 2, 101-107 p.
Keyword [en]
schemic stroke, secondary prevention, statins, medication adherence, socioeconomic factors
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-119790DOI: 10.1177/2396987316646026OAI: oai:DiVA.org:umu-119790DiVA: diva2:923807
Available from: 2016-04-27 Created: 2016-04-27 Last updated: 2016-09-14Bibliographically approved

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Sjölander, MariaEriksson, MarieGlader, Eva-Lotta
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