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Are doctors using more preventive medication for cardiovascular disease?: A Swedish cross-sectional study
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.ORCID iD: 0000-0002-8854-498x
Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.ORCID iD: 0000-0002-3972-5362
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.ORCID iD: 0000-0003-4095-6501
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2023 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 41, no 3, p. 297-305Article in journal (Refereed) Published
Abstract [en]

Background: 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.

Place, publisher, year, edition, pages
Taylor & Francis, 2023. Vol. 41, no 3, p. 297-305
Keywords [en]
cardiovascular disease, epidemiology, Healthcare inequities, pharmacoepidemiology, prevention
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-212491DOI: 10.1080/02813432.2023.2234439ISI: 001029892800001PubMedID: 37467115Scopus ID: 2-s2.0-85165481697OAI: oai:DiVA.org:umu-212491DiVA, id: diva2:1785215
Funder
Västerbotten County CouncilAvailable from: 2023-08-01 Created: 2023-08-01 Last updated: 2023-09-27Bibliographically approved

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Lillqvist, JoelNilsson Sommar, JohanGustafsson, Per EGlader, Eva-LottaHamberg, KatarinaRolandsson, Olov

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Lillqvist, JoelNilsson Sommar, JohanGustafsson, Per EGlader, Eva-LottaHamberg, KatarinaRolandsson, Olov
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Department of Public Health and Clinical MedicineSection of Sustainable HealthDepartment of Epidemiology and Global Health
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Scandinavian Journal of Primary Health Care
Public Health, Global Health, Social Medicine and Epidemiology

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