Prescribing in general practice for people with coronary heart disease; equity by age, sex, ethnic group and deprivation

Ethn Health. 2011 Apr;16(2):107-23. doi: 10.1080/13557858.2010.540312.

Abstract

Objective: Differences in drug prescribing for coronary heart disease have previously been identified by age, sex and ethnic group. Set in the UK, our study utilises routinely collected data from 98 general practices serving a socially diverse population in inner East London, to examine differences in prescribing rates among patients aged 35 years and over with coronary heart disease.

Design: 10,933 patients aged 35 years or more, with recorded coronary heart disease, from 98 practices in two Primary Care Trusts (PCT) in East London during 2009/2010 were included for this cross-sectional study. Multivariable logistic regression was used to assess the odds of prescribing for recommended coronary heart disease drugs by age, sex, ethnicity, social deprivation, co-morbidity and recorded reasons for not prescribing.

Results: Women are prescribed fewer recommended coronary heart disease drugs than men; Black African/Caribbean patients are prescribed fewer lipid modifying drugs and other cardiovascular drugs than White patients. Patients over age 84 are prescribed fewer lipid modifying drugs and beta blockers than patients aged 45-54. South Asian patients had the highest levels of prescribing and higher prevalence of coronary heart disease and diabetes co-morbidity. No difference in prescribing rates by social deprivation was found.

Discussion: Overall levels of prescribing are high but small differences between sex and ethnic groups remain and prescribing may be inequitable for women, for Black/African Caribbeans and at older ages. These differences were not explained by recorded intolerance, contraindications or declining treatment.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Coronary Disease / drug therapy*
  • Coronary Disease / epidemiology
  • Coronary Disease / ethnology*
  • Cross-Sectional Studies
  • Diabetes Mellitus / epidemiology
  • Ethnic Groups*
  • Family Practice / statistics & numerical data*
  • Female
  • Health Services Accessibility
  • Healthcare Disparities*
  • Humans
  • London / ethnology
  • Male
  • Middle Aged
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Prevalence
  • Sex Distribution
  • Socioeconomic Factors