Social deprivation and statin prescribing: a cross-sectional analysis using data from the new UK general practitioner 'Quality and Outcomes Framework'
Social deprivation and statin prescribing: a cross-sectional analysis using data from the new UK general practitioner 'Quality and Outcomes Framework'
复制标题
DOI：
10.1093/pubmed/fdl068
复制
发表时间：
2007-03-01
影响因子：
4.4
通讯作者：
Rowlands, G.
中科院分区：
文献类型：
--
作者：
Ashworth, M.;Lloyd, D.;Rowlands, G.
我们的目的是研究降脂药物处方、社会剥夺和其他一般医疗特征之间的关系。 2004 年 5 月，我们对英格兰的所有一般做法进行了横断面调查。对于每种做法，获得以下变量：降脂药物的标准化成本和数量数据、一般做法的描述符、2004 年多重剥夺指数、2001 年人口普查的种族数据以及质量和结果框架数据。构建的回归模型解释了全科医生他汀类药物处方中 34.5% 的差异。最有力的预测因素是更高的社会剥夺、更高的冠心病患病率以及糖尿病患者胆固醇目标的实现。实践中老年患者的比例以及南亚和非裔加勒比患者的比例都显示出负回归系数。总之，与之前的当地研究相反，我们发现，即使在对疾病患病率增加和与贫困相关的实践变量进行调整之后，在较贫困的社区中他汀类药物的处方量也较高。他汀类药物处方也与成功实现已确定疾病的胆固醇目标（二级预防）独立相关。然而，我们的研究结果表明，对老年人以及少数族裔的他汀类药物处方不足。
We aimed to study the relationship between the prescribing of lipid-lowering medication, social deprivation and other general practice characteristics. We conducted a cross-sectional survey of all general practices in England, 2004-05. For each practice, the following variables were obtained: standardized cost and volume data for lipid-lowering medication, descriptors of general practices, Index of Multiple Deprivation, 2004, ethnicity data from the 2001 Census and Quality and Outcomes Framework data. A regression model was constructed which explained 34.5% of the variation in statin prescribing by general practitioners. The most powerful predictors were higher social deprivation, higher prevalence of coronary heart disease and achievement of cholesterol targets for diabetics. Negative regression coefficients were demonstrated for the proportion of elderly patients in the practice and, to a lesser extent, for the proportion of south Asian and Afro-Caribbean patients. In conclusion, contrary to previous local studies, we found that statin prescribing was higher in more deprived communities, even after adjustment for increased disease prevalence and practice variables associated with deprivation. Statin prescribing was also independently associated with success at achieving cholesterol targets in established disease (secondary prevention). However, our findings suggest under-prescribing of statins to the elderly and possibly also to ethnic minorities.