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Are doctors using more preventive medication for cardiovascular disease? A Swedish cross-sectional study

Despite decreasing mortality from cardiovascular disease (CVD), there are persistent inequities in mortality between socioeconomic groups. Primary preventative medications reduce mortality in CVD; thus, inequitable treatments will contribute to unequal outcomes. Physicians might contribute to inequa...

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Published in:Scandinavian journal of primary health care 2023-09, Vol.ahead-of-print (ahead-of-print), p.1-9
Main Authors: Lillqvist, Joel, Sommar, Johan N., Gustafsson, Per E., Glader, Eva-Lotta, Hamberg, Katarina, Rolandsson, Olov
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description Despite decreasing mortality from cardiovascular disease (CVD), there are persistent inequities in mortality between socioeconomic groups. Primary preventative medications reduce mortality in CVD; thus, inequitable treatments will contribute to unequal outcomes. Physicians might contribute to inequality by prescribing preventative medication for CVD to themselves in a biased manner. To determine whether primary medications for preventing CVD were prescribed inequitably between physicians and non-physicians. This retrospective study retrieved registry data on prescribed medications for all physicians in Sweden aged 45-74 years, during 2013, and for reference non-physician individuals, matched by sex, age, residence, and level of education. The outcome was any medication for preventing CVD, received at least once during 2013. Age and the sex-specific prevalence of myocardial infarction (MI) among physicians and non-physicians were used as a proxy for the need for medication. Thereafter, to limit the analysis to preventative medication, we excluded individuals that were diagnosed with CVD or diabetes. To analyse differences in medication usage between physicians and matched non-physicians, we estimated odds ratios (ORs) with conditional logistic regression and adjusted for need and household income. MI prevalences were 5.7% for men and 2.3% for women, among physicians, and 5.4% for men and 1.8% for women, among non-physicians. We included 25,105 physicians and 44,366 non-physicians. The OR for physicians receiving any CVD preventative medication, compared to non-physicians, was 1.65 (95% confidence interval 1.59-1.72). We found an inequity in prescribed preventative CVD medications, which favoured physicians over non-physicians.
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subjects Cardiovascular disease
Cardiovascular diseases
Cross-sectional studies
Diabetes
Drugs
epidemiology
Family physicians
Healthcare inequities
Inequality
Mortality
Myocardial infarction
pharmacoepidemiology
Physicians
Prescribing
Prescriptions
prevention
Preventive medicine
title Are doctors using more preventive medication for cardiovascular disease? A Swedish cross-sectional study
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