Gender and racial disparities in adherence to statin therapy: A meta-analysis
Gender and racial disparities in adherence to statin therapy: A meta-analysis
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DOI：
10.1016/j.ahj.2013.02.011
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发表时间：
2013-05-01
影响因子：
4.8
通讯作者：
Choudhry, Niteesh K.
中科院分区：
文献类型：
--
作者：
Lewey, Jennifer;Shrank, William H.;Choudhry, Niteesh K.
背景心血管结局在种族/民族和性别上存在显著差异。基于证据的药物使用率和长期药物依从性在种族亚组和女性中似乎也较低，但很少受到关注。我们的目的是评估种族/民族和性别对坚持他汀类药物治疗的一级或二级prevention.Methods和结果的影响，通过系统检索MEDLINE，EMBASE，ClinicalTrials.gov，和科克伦数据库的系统评价（通过2010年4月1日）和手动检查选定的文章中的参考文献。纳入了报告男性和女性或白色和非白色人种患者对他汀类药物依从性的研究。使用标准化方案提取研究设计、依从性测量、持续时间、地理位置、样本量和患者人口统计学信息。从3，022篇潜在相关出版物中，纳入了53项研究。与男性相比，女性不依从的几率高出10%（比值比1.10，95%置信区间[CI]，1.07-1.13）。非白色人种患者的不依从性比白色人种患者高53%（比值比1.53，95% CI 1.25-1.87）。性别的合并估计值存在显著异质性（I-2 0.95，异质性P值
Background Significant disparities exist in cardiovascular outcomes based on race/ethnicity and gender. Rates of evidence-based medication use and long-term medication adherence also appear to be lower in racial subgroups and women but have been subject to little attention. Our objective was to evaluate the effect of race/ethnicity and gender on adherence to statin therapy for primary or secondary prevention.Methods and results Studies were identified through a systematic search of MEDLINE, EMBASE, ClinicalTrials.gov, and the Cochrane Database of Systematic Reviews (through April 1, 2010) and manual examination of references in selected articles. Studies reporting on adherence to statins by men and women or patients of white and nonwhite race were included. Information on study design, adherence measurement, duration, geographic location, sample size, and patient demographics was extracted using a standardized protocol. From 3,022 potentially relevant publications, 53 studies were included. Compared with men, women had a 10% greater odds of nonadherence (odds ratio 1.10, 95% confidence interval [CI], 1.07-1.13). Nonwhite race patients had a 53% greater odds of nonadherence than white race patients (odds ratio 1.53, 95% CI 1.25-1.87). There was significant heterogeneity in the pooled estimate for gender (I-2 0.95, P value for heterogeneity