Centre for Health Sciences, Institute of Health Sciences Education, Barts & The London School of Medicine and Dentistry, Queen Mary, University of London, London, UK.
Ethn Health. 2011 Apr;16(2):107-23. doi: 10.1080/13557858.2010.540312.
Differences in drug prescribing for coronary heart disease have previously been identified by age, sex and ethnic group. Set in the UK, our study utilises routinely collected data from 98 general practices serving a socially diverse population in inner East London, to examine differences in prescribing rates among patients aged 35 years and over with coronary heart disease.
10,933 patients aged 35 years or more, with recorded coronary heart disease, from 98 practices in two Primary Care Trusts (PCT) in East London during 2009/2010 were included for this cross-sectional study. Multivariable logistic regression was used to assess the odds of prescribing for recommended coronary heart disease drugs by age, sex, ethnicity, social deprivation, co-morbidity and recorded reasons for not prescribing.
Women are prescribed fewer recommended coronary heart disease drugs than men; Black African/Caribbean patients are prescribed fewer lipid modifying drugs and other cardiovascular drugs than White patients. Patients over age 84 are prescribed fewer lipid modifying drugs and beta blockers than patients aged 45-54. South Asian patients had the highest levels of prescribing and higher prevalence of coronary heart disease and diabetes co-morbidity. No difference in prescribing rates by social deprivation was found.
Overall levels of prescribing are high but small differences between sex and ethnic groups remain and prescribing may be inequitable for women, for Black/African Caribbeans and at older ages. These differences were not explained by recorded intolerance, contraindications or declining treatment.
先前已确定年龄、性别和种族对冠心病药物处方的差异。我们的研究以英国为背景，利用来自东伦敦市中心 98 家服务于社会多样化人群的普通诊所的常规收集数据，来检查 35 岁及以上患有冠心病的患者中，不同年龄、性别、种族、社会经济剥夺程度、合并症和未开处方原因的患者的处方率差异。
本横断面研究纳入了来自东伦敦两个初级保健信托机构（PCT）的 98 家普通诊所的 10933 名年龄在 35 岁及以上、有记录的冠心病患者。采用多变量逻辑回归来评估按年龄、性别、种族、社会经济剥夺程度、合并症和未开处方原因进行推荐的冠心病药物处方的可能性。
与男性相比，女性接受的推荐冠心病药物较少；与白人患者相比，黑非洲/加勒比患者接受的降脂药物和其他心血管药物较少。84 岁以上的患者接受的降脂药物和β受体阻滞剂比 45-54 岁的患者少。南亚患者的处方量最高，冠心病和糖尿病合并症的患病率也较高。未发现社会经济剥夺程度与处方率之间存在差异。
总的来说，处方水平较高，但性别和种族群体之间仍存在较小差异，女性、黑非洲/加勒比人和年龄较大的患者的处方可能不公平。这些差异不能用记录的不耐受、禁忌症或治疗下降来解释。
