Optimal Medical Therapy Prescribing Patterns and Disparities Identified in Patients with Acute Coronary Syndromes at an Academic Medical Center in an Area with High Coronary Heart Disease-Related Mortality
| Autor: | Jamie L. Miller, Ashley N Fox, Nicholas C. Schwier, Grant H. Skrepnek, Toni L. Ripley |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Medication Therapy Management Coronary Disease Comorbidity 030204 cardiovascular system & hematology Drug Prescriptions Risk Assessment Cohort Studies 03 medical and health sciences 0302 clinical medicine Pharmacotherapy Internal medicine medicine Humans Pharmacology (medical) Registries 030212 general & internal medicine Acute Coronary Syndrome Healthcare Disparities Aged Retrospective Studies Aged 80 and over Academic Medical Centers business.industry Unstable angina Retrospective cohort study General Medicine Odds ratio Middle Aged medicine.disease Black or African American Regimen Female Cardiology and Cardiovascular Medicine Risk assessment business Cohort study |
| Zdroj: | American Journal of Cardiovascular Drugs. 19:185-193 |
| ISSN: | 1179-187X 1175-3277 |
| DOI: | 10.1007/s40256-018-0308-x |
| Popis: | Coronary heart disease (CHD)-related mortality is high in the southern United States. A five-drug pharmacotherapy regimen for acute coronary syndromes (ACS), defined as optimal medical therapy (OMT), can decrease CHD-related mortality. Studies have indicated that OMT is prescribed 50–60% of the time. Assessment of prescribing could provide insight into the potential etiology of disparate mortality. The aim was to evaluate prescribing of OMT at discharge in patients presenting with an ACS event at an academic medical center and identify patients at risk of not receiving OMT. A single-center, retrospective cohort of patients with ACS diagnosis between July 2013 and July 2015 was investigated, and a multivariable regression analysis conducted to identify populations at risk of not receiving OMT. A total of 864 patients were identified by International Classification of Diseases, Ninth Revision (ICD-9) codes, with 533 excluded and 331 analyzed. OMT was prescribed in 69.79%. Patients ≥ 75 years of age [p = 0.003; odds ratio (OR) 0.30; 95% confidence interval (CI) 0.136–0.673], unstable angina presentation (p = 0.042; OR 0.55; 95% CI 0.307–0.977), and surgical management (p = 0.001; OR 0.22; 95% CI 0.095–0.519) were less likely to receive OMT. The percentage of patients prescribed OMT exceeded the reported global percentage of prescribed OMT. However, disparities exist among specific populations. |
| Databáze: | OpenAIRE |
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