Racial differences in statin adherence following hospital discharge for ischemic stroke.

Abstract:

OBJECTIVE:To compare nonadherence to statins in older black and white adults following an ischemic stroke. METHODS:We studied black and white adults ≥66 years of age with Medicare fee-for-service insurance coverage hospitalized for ischemic stroke from 2007 to 2012 who filled a statin prescription within 30 days following discharge. Nonadherence was defined as a proportion of days covered <80% in the 365 days following hospital discharge. In addition, we evaluated factors associated with nonadherence for white and black participants separately. RESULTS:Overall 2,763 beneficiaries met the inclusion criteria (13.5% black). Black adults were more likely than white adults to be nonadherent (49.7% vs 41.5%) even after adjustment for demographics, receipt of a low-income subsidy, and baseline comorbidities (adjusted relative risk [RR] 1.14, 95% confidence interval [CI] 1.01-1.29). Among white adults, receipt of a low-income subsidy (adjusted RR 1.13, 95% CI 1.02-1.26), history of coronary heart disease (adjusted RR 1.15, 95% CI 1.01-1.30), and discharge directly home following stroke hospitalization (adjusted RR 1.26, 95% CI 1.10-1.44) were associated with a higher risk of nonadherence. Among black adults, a 1-unit increase in the Charlson comorbidity index (adjusted RR 1.04, 95% CI 1.01-1.09), history of carotid artery disease (adjusted RR 2.38, 95% CI 1.08-5.25), and hospitalization during the 365 days prior to the index stroke (adjusted RR 1.34, 95% CI 1.01-1.78) were associated with nonadherence. CONCLUSIONS:Compared with white adults, black adults were more likely to be nonadherent to statins following hospitalization for ischemic stroke.

journal_name

Neurology

journal_title

Neurology

authors

Albright KC,Zhao H,Blackburn J,Limdi NA,Beasley TM,Howard G,Bittner V,Howard VJ,Muntner P

doi

10.1212/WNL.0000000000003910

subject

Has Abstract

pub_date

2017-05-09 00:00:00

pages

1839-1848

issue

19

eissn

0028-3878

issn

1526-632X

pii

WNL.0000000000003910

journal_volume

88

pub_type

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