Niska Richard, Han Beth
Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, Maryland, USA.
J Natl Med Assoc. 2009 Jul;101(7):705-10. doi: 10.1016/s0027-9684(15)30980-9.
To examine statin prescribing for secondary cardiovascular disease prevention at primary care visits by older patients in 2005-2006.
The National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey are cross-sectional, using a multistage random sample (112 primary sampling units, physicians and hospitals, patient visits). Characteristics from 4964 primary care visits were abstracted from medical records. Chi2 and logistic regression were performed to investigate associations with statin prescribing.
US nonfederal physician offices and hospital outpatient departments.
Visits by patients aged 55 to 80 years with cerebrovascular, ischemic heart or peripheral vascular disease, aortic aneurysm, atherosclerosis, diabetes mellitus, or any 2 risk factors (hyperlipidemia, hypertension, or smoking).
The dependent variable was statin prescribing. Independent variables were age, sex, ethnicity, primary payment source, number of comorbidities, metropolitan statistical area, geographic region, and clinical setting.
Statins were prescribed at 37.7% of visits. Logistic regression negative predictors for statin prescribing included non-Hispanic black ethnicity and Medicaid coverage. Number of comorbidities was a positive predictor.
Statins are prescribed at much fewer visits by higher-risk older patients, especially non-Hispanic black patients and Medicaid beneficiaries, than would be expected from their comorbidities.
调查2005 - 2006年老年患者在基层医疗就诊时他汀类药物用于二级心血管疾病预防的处方情况。
国家门诊医疗调查和国家医院门诊医疗调查采用多阶段随机抽样（112个初级抽样单位，医生和医院，患者就诊情况），属于横断面研究。从4964次基层医疗就诊记录中提取相关特征。采用卡方检验和逻辑回归分析来研究与他汀类药物处方的相关性。
美国非联邦医生办公室和医院门诊部。
年龄在55至80岁之间，患有脑血管疾病、缺血性心脏病、外周血管疾病、主动脉瘤、动脉粥样硬化、糖尿病或具备任意两种危险因素（高脂血症、高血压或吸烟）的患者就诊情况。
因变量为他汀类药物处方。自变量包括年龄、性别、种族、主要支付来源、合并症数量、大都市统计区、地理区域和临床环境。
37.7%的就诊患者开具了他汀类药物。他汀类药物处方的逻辑回归负向预测因素包括非西班牙裔黑人种族和医疗补助覆盖情况。合并症数量是正向预测因素。
与根据合并症情况预期的相比，高危老年患者，尤其是非西班牙裔黑人患者和医疗补助受益人的他汀类药物处方就诊次数要少得多。
