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Gender inequalities in cardiovascular risk factor assessment and management in primary healthcare.

TitleGender inequalities in cardiovascular risk factor assessment and management in primary healthcare.
Publication TypeJournal Article
Year of Publication2017
AuthorsHyun, KK, Redfern, J, Patel, A, D, P, Brieger, D, Sullivan, D, Harris, M, Usherwood, T, Macmahon, S, Lyford, M, Woodward, M
JournalHeart
Volume103
Issue7
Pagination492-498
Date Published04/2017
ISSN1468-201X
KeywordsAdult, Age Factors, Aged, Anticoagulants, Antihypertensive Agents, Cardiovascular Diseases, Chi-Square Distribution, Decision Support Techniques, Drug Prescriptions, Female, Guideline Adherence, Healthcare Disparities, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Logistic Models, Male, Middle Aged, Multivariate Analysis, New South Wales, Odds Ratio, Platelet Aggregation Inhibitors, Practice Guidelines as Topic, Practice Patterns, Physicians', Primary Health Care, Primary Prevention, Queensland, Randomized Controlled Trials as Topic, Risk Assessment, Risk Factors, Sex Factors, Time Factors, Treatment Outcome
Abstract

OBJECTIVES: To quantify contemporary differences in cardiovascular disease (CVD) risk factor assessment and management between women and men in Australian primary healthcare services.

METHODS: Records of routinely attending patients were sampled from 60 Australian primary healthcare services in 2012 for the Treatment of Cardiovascular Risk using Electronic Decision Support study. Multivariable logistic regression models were used to compare the rate of CVD risk factor assessment and recommended medication prescriptions, by gender.

RESULTS: Of 53 085 patients, 58% were female. Adjusting for demographic and clinical characteristics, women were less likely to have sufficient risk factors measured for CVD risk assessment (OR (95% CI): 0.88 (0.81 to 0.96)). Among 13 294 patients (47% women) in the CVD/high CVD risk subgroup, the adjusted odds of prescription of guideline-recommended medications were greater for women than men: 1.12 (1.01 to 1.23). However, there was heterogeneity by age (p <0.001), women in the CVD/high CVD risk subgroup aged 35-54 years were less likely to be prescribed the medications (0.63 (0.52 to 0.77)), and women in the CVD/high CVD risk subgroup aged ≥65 years were more likely to be prescribed the medications (1.34 (1.17 to 1.54)) than their male counterparts.

CONCLUSIONS: Women attending primary healthcare services in Australia were less likely than men to have risk factors measured and recorded such that absolute CVD risk can be assessed. For those with, or at high risk of, CVD, the prescription of appropriate preventive medications was more frequent in older women, but less frequent in younger women, compared with their male counterparts.

TRIAL REGISTRATION NUMBER: 12611000478910, Pre-results.

DOI10.1136/heartjnl-2016-310216
Alternate JournalHeart
PubMed ID28249996
English
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