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Socioeconomic position and secondary preventive therapy after an AMI.

Ohlsson, Henrik LU ; Rosvall, Maria LU ; Hansen, Ole LU ; Chaix, Basile LU and Merlo, Juan LU (2010) In Pharmacoepidemiology and Drug Safety 19. p.358-366
Abstract
PURPOSE: To investigate the association between socioeconomic position and use of lipid-lowering drugs and ACE-inhibitors after an acute myocardial infarction (AMI) when simultaneously considering participation in the national quality register RIKS-HIA (Register of Information and Knowledge about Swedish Heart Intensive care Admissions), age, sex and previous hospitalizations of the patients. METHODS: Population-based prospective cohort study included all 1346 AMI patients cared in the county of Scania, Sweden during 2006 of whom 1061 were register at the RIKS-HIA. Treatment with lipid-lowering and ACE-inhibiting therapy in relation to income was investigated with Cox and logistic regression modelling. RESULTS: In the whole population of... (More)
PURPOSE: To investigate the association between socioeconomic position and use of lipid-lowering drugs and ACE-inhibitors after an acute myocardial infarction (AMI) when simultaneously considering participation in the national quality register RIKS-HIA (Register of Information and Knowledge about Swedish Heart Intensive care Admissions), age, sex and previous hospitalizations of the patients. METHODS: Population-based prospective cohort study included all 1346 AMI patients cared in the county of Scania, Sweden during 2006 of whom 1061 were register at the RIKS-HIA. Treatment with lipid-lowering and ACE-inhibiting therapy in relation to income was investigated with Cox and logistic regression modelling. RESULTS: In the whole population of AMI patients, high income patients had a higher adherence to guidelines for pharmacological secondary prevention than low income patients (HR(lipid-lowering drug): 1.29; 95%CI: 1.12-1.49 and HR(ACE-inhibitor therapy): 1.22; 95%CI: 1.04-1.43). Among RIKS-HIA participants, patients with high income presented a better adherence to lipid-lowering treatment than patients with low income (HR: 1.15; 95%CI: 0.98-1.34). CONCLUSION: Our investigation reveals that the Swedish goal of access to health care on equal terms and according to needs is still not fully accomplished. Moreover, since this pattern of inequity in pharmacological secondary prevention may lead to the recurrence of heart disease, these inequities are not only a matter of fairness and social justice, but also a potential (and modifiable) source of ineffectiveness and inefficiency in health care. Copyright (c) 2010 John Wiley & Sons, Ltd. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Pharmacoepidemiology and Drug Safety
volume
19
pages
358 - 366
publisher
John Wiley & Sons
external identifiers
  • wos:000276929100005
  • pmid:20087850
  • scopus:77950895259
ISSN
1053-8569
DOI
10.1002/pds.1917
language
English
LU publication?
yes
id
d949140b-e058-4ba8-896a-fd06af68a9ee (old id 1540788)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20087850?dopt=Abstract
date added to LUP
2010-02-04 14:43:44
date last changed
2018-05-29 11:32:43
@article{d949140b-e058-4ba8-896a-fd06af68a9ee,
  abstract     = {PURPOSE: To investigate the association between socioeconomic position and use of lipid-lowering drugs and ACE-inhibitors after an acute myocardial infarction (AMI) when simultaneously considering participation in the national quality register RIKS-HIA (Register of Information and Knowledge about Swedish Heart Intensive care Admissions), age, sex and previous hospitalizations of the patients. METHODS: Population-based prospective cohort study included all 1346 AMI patients cared in the county of Scania, Sweden during 2006 of whom 1061 were register at the RIKS-HIA. Treatment with lipid-lowering and ACE-inhibiting therapy in relation to income was investigated with Cox and logistic regression modelling. RESULTS: In the whole population of AMI patients, high income patients had a higher adherence to guidelines for pharmacological secondary prevention than low income patients (HR(lipid-lowering drug): 1.29; 95%CI: 1.12-1.49 and HR(ACE-inhibitor therapy): 1.22; 95%CI: 1.04-1.43). Among RIKS-HIA participants, patients with high income presented a better adherence to lipid-lowering treatment than patients with low income (HR: 1.15; 95%CI: 0.98-1.34). CONCLUSION: Our investigation reveals that the Swedish goal of access to health care on equal terms and according to needs is still not fully accomplished. Moreover, since this pattern of inequity in pharmacological secondary prevention may lead to the recurrence of heart disease, these inequities are not only a matter of fairness and social justice, but also a potential (and modifiable) source of ineffectiveness and inefficiency in health care. Copyright (c) 2010 John Wiley & Sons, Ltd.},
  author       = {Ohlsson, Henrik and Rosvall, Maria and Hansen, Ole and Chaix, Basile and Merlo, Juan},
  issn         = {1053-8569},
  language     = {eng},
  pages        = {358--366},
  publisher    = {John Wiley & Sons},
  series       = {Pharmacoepidemiology and Drug Safety},
  title        = {Socioeconomic position and secondary preventive therapy after an AMI.},
  url          = {http://dx.doi.org/10.1002/pds.1917},
  volume       = {19},
  year         = {2010},
}