National Research and Development Centre for Welfare and Health, Health Services Research, P,O,Box 220, 00531 Helsinki, Finland.
Int J Equity Health. 2008 Jun 30;7:16. doi: 10.1186/1475-9276-7-16.
Earlier studies have mainly reported the use of antithrombotic drugs, beta-blockers and statins among hospital patient populations or MI patients. This study aimed to describe the use of these drugs among middle-aged Finnish coronary patients and to identify patient groups in risk of being prescribed inadequate medication for secondary prevention of coronary heart disease.
One-year follow-up survey data from a random sample of a cohort of coronary patients were used along with register data linked to the survey. The response rate was 54% (n = 2650). The main outcome measures were use of antithrombotic drugs, beta-blockers and statins and the data were analysed using logistic regression analysis.
Among men and women, respectively, 82% and 81% used beta-blockers, 95% and 89% used antithrombotic drugs, and 62% and 59% used statins. Younger men and men from higher socioeconomic groups were more likely to use statins, even after controlling for disease severity and comorbidity. In women, the age trend was reversed and no socioeconomic differences were found. Drug use increased with increased disease severity, but diabetes had only a slight effect.
The use of antithrombotic drugs and beta-blockers among Finnish coronary patients seemed to be rather appropriate and, to some extent, prescription practices of preventive medication varied according to patients' risk of coronary events. However, statin use was remarkably low among men with low socio-economic status, and there is need to improve preventive drug treatment among diabetic coronary patients.
早期的研究主要报告了抗血栓药物、β受体阻滞剂和他汀类药物在医院患者人群或心肌梗死患者中的应用。本研究旨在描述这些药物在芬兰中年冠心病患者中的使用情况,并确定存在冠心病二级预防药物治疗不足风险的患者群体。
使用了一项冠心病患者队列的随机样本的一年随访调查数据,并将这些数据与调查相关的登记数据进行了关联。应答率为 54%(n=2650)。主要结局指标为抗血栓药物、β受体阻滞剂和他汀类药物的使用情况,并使用逻辑回归分析对数据进行了分析。
在男性和女性中,分别有 82%和 81%使用了β受体阻滞剂,95%和 89%使用了抗血栓药物,62%和 59%使用了他汀类药物。年轻男性和社会经济地位较高的男性更有可能使用他汀类药物,即使在控制了疾病严重程度和合并症之后也是如此。在女性中,年龄趋势相反,且没有发现社会经济差异。药物使用随着疾病严重程度的增加而增加,但糖尿病的影响较小。
芬兰冠心病患者使用抗血栓药物和β受体阻滞剂的情况似乎相当合适,并且在一定程度上,预防药物的处方实践根据患者发生冠心病事件的风险而有所不同。然而,社会经济地位较低的男性中他汀类药物的使用率显著较低,需要改善糖尿病冠心病患者的预防药物治疗。