Recording a diagnosis of stroke, transient ischaemic attack or myocardial infarction in primary healthcare and the association with dispensation of secondary preventive medication: a registry-based prospective cohort study
| Autor: | Mia von Euler, Jan Hasselström, Cecilia Dahlgren, Lukas Geary, Clas Rehnberg, Karin Schenck-Gustafsson, Per Wändell |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Pediatrics Myocardial Infarction 030204 cardiovascular system & hematology law.invention 0302 clinical medicine law Secondary Prevention Medicine Prospective Studies Registries 030212 general & internal medicine Myocardial infarction Prospective cohort study Stroke Aged 80 and over Clinical pharmacology General Medicine Middle Aged stroke Patient Discharge Health Records Personal Ischemic Attack Transient Female Health Services Research Adult medicine.medical_specialty Acute coronary syndrome Primary care preventive medicine Medication Adherence quality in health care primary care 03 medical and health sciences Humans cardiovascular diseases Medical prescription Antihypertensive Agents Aged Preventive healthcare Sweden Primary Health Care business.industry Research medicine.disease Drug Utilization Logistic Models Emergency medicine clinical pharmacology Hydroxymethylglutaryl-CoA Reductase Inhibitors business |
| Zdroj: | BMJ Open |
| ISSN: | 2044-6055 |
| Popis: | ObjectivesThe aim of this study was to explore whether recording in primary care of a previously recorded hospital diagnosis was associated with increased patient utilisation of recommended medications.DesignRegistry-based prospective cohort study.Setting and participants19 072 patients with a hospital discharge diagnosis of transient ischaemic attack (TIA), stroke or acute coronary syndrome from hospitals in Stockholm County 2010–2013 were included in the study.Main outcome measureThe outcome of the study was medication dispensation as a marker of adherence to recommended medications. Adherence was defined as having had at least two filled prescriptions in the third year following hospital discharge.ResultsRecording a diagnosis was associated with higher utilisation of all recommended medications with the exception of antihypertensives in patients with TIA. The differences between the groups with and without a recorded diagnosis remained after adjusting for age, sex, index year and visits to private practitioners. Dispensation of antithrombotics was high overall, 80%–90% in patients without a recorded diagnosis and 90%–94% for those with a diagnosis. Women with recorded ischaemic stroke/TIA/acute coronary syndrome were dispensed more statins (56%–71%) than those with no recorded diagnosis (46%–59%). Similarly, 68%–83% of men with a recorded diagnosis were dispensed statins (57%–77% in men with no recorded diagnosis). The rate of diagnosis recording spanned from 15% to 47% and was especially low in TIA (men 15%, women 16%).ConclusionRecording a diagnosis of TIA/stroke or acute coronary syndrome in primary care was found to be associated with higher dispensation of recommended secondary preventive medications. Further study is necessary in order to determine the mechanisms underlying our results and to establish the utility of our findings. |
| Databáze: | OpenAIRE |
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