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Socioeconomic position and secondary preventive therapy after an AMI.

In English

Författare

Summary, in English

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.

Publiceringsår

2010

Språk

Engelska

Sidor

358-366

Publikation/Tidskrift/Serie

Pharmacoepidemiology and Drug Safety

Volym

19

Dokumenttyp

Artikel i tidskrift

Förlag

John Wiley & Sons Inc.

Ämne

  • Environmental Health and Occupational Health
  • Clinical Medicine

Status

Published

Forskningsgrupp

  • Social Epidemiology

ISBN/ISSN/Övrigt

  • ISSN: 1053-8569