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社区卫生中心患者他汀类药物处方中的性别、种族和语言差异。

Sex, ethnicity and language differences in statin prescribing in community health center patients.

作者信息

Hodes Tahlia, Marino Miguel, Kaufmann Jorge, Lucas Jennifer A, Giebultowicz Sophia, Heintzman John

机构信息

Department of Family Medicine, Oregon Health & Science University, USA.

OCHIN, Inc, USA.

出版信息

Am J Prev Cardiol. 2024 Oct 5;20:100873. doi: 10.1016/j.ajpc.2024.100873. eCollection 2024 Dec.

Abstract

BACKGROUND

Statins have been shown to reduce atherosclerotic cardiovascular disease (ASCVD). In the United States, statins are underutilized, and the literature suggests women and Latine individuals received even fewer prescriptions than men even when eligible. No study has shown how statins are prescribed when looking at language, ethnicity, and considering sex.

METHODS

Data were analyzed from a multistate EHR network across the US from 2014 to 2020. We included patients aged 40+ that were non-Hispanic White, English speaking Latine, and Spanish speaking Latine and further disaggregated by sex with the aim to examine statin prescription prevalence and rates between groups. GEE logistic and negative binomial regression models were used determine the outcomes adjusted by appropriate covariates.

RESULTS

We found compared to non-Hispanic White men, only Spanish speaking Latinos had higher odds of receiving a statin prescription, but once one statin was prescribed, non-Hispanic White women were the only group with higher rates. We found a higher percent of Spanish speaking Latine patients regardless of sex had a statin prescription. Prevalence of having a statin prescription was 59.3 % and 59.7 % for Spanish speaking Latinos and Latinas respectively compared to 55.5 % 57.0 % for non-Hispanic White men and women respectively.

CONCLUSIONS

Overall, we found ethnicity, language, and sex differences. Clinicians in CHCs play an important role in the process to eliminate the sex gap in preventive health. The attention to statin prescribing in Spanish speaking Latine patients indicates more conscious care is being implemented in these vulnerable populations.

摘要

背景

他汀类药物已被证明可降低动脉粥样硬化性心血管疾病(ASCVD)。在美国,他汀类药物未得到充分利用,而且文献表明,即使符合条件,女性和拉丁裔个体获得的处方也比男性少。尚无研究探讨在考虑语言、种族和性别的情况下他汀类药物是如何开具处方的。

方法

对2014年至2020年美国多州电子健康记录(EHR)网络的数据进行分析。我们纳入了40岁及以上的非西班牙裔白人、说英语的拉丁裔和说西班牙语的拉丁裔患者,并按性别进一步细分,旨在研究他汀类药物处方的患病率和不同组之间的比率。使用广义估计方程(GEE)逻辑回归和负二项回归模型来确定经适当协变量调整后的结果。

结果

我们发现,与非西班牙裔白人男性相比,只有说西班牙语的拉丁裔获得他汀类药物处方的几率更高,但一旦开具了一种他汀类药物,非西班牙裔白人女性是唯一处方率更高的群体。我们发现,无论性别如何,说西班牙语的拉丁裔患者中开具他汀类药物处方的比例更高。说西班牙语的拉丁裔男性和女性开具他汀类药物处方的患病率分别为59.3%和59.7%,而非西班牙裔白人男性和女性的这一比例分别为55.5%和57.0%。

结论

总体而言,我们发现了种族、语言和性别差异。社区卫生中心的临床医生在消除预防性健康方面的性别差距过程中发挥着重要作用。对说西班牙语的拉丁裔患者开具他汀类药物的关注表明,在这些弱势群体中正在实施更具针对性的护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae32/11755339/7959f817a44c/gr2.jpg

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