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Centre for Policy on Ageing | |
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Sociodemographic variations in the contribution of secondary drug prevention to stroke survival at middle and older ages
— cohort study | | Author(s) | Rosalind Raine, Wun Wong, Gareth Ambler |
| Journal title | British Medical Journal, vol 338, no 7703, 9 May 2009 |
| Pages | pp 1122-1131 |
| Source | www.bmj.com |
| Keywords | Stroke ; Economic status [elderly] ; Drugs ; Aftercare ; General practice ; Longitudinal surveys. |
| Annotation | Recent research in the contribution of medical care to population health has focused on the reduction in mortality from coronary heart disease (CHD). However, the contribution of medical care for other major conditions, including stroke, has not been quantified. This cohort study used data from the health improvement network primary care database for 12830 patients aged 50+ from 113 general practices who had a stroke between 1995 and 2005, and who survived the first 30 days after stroke. Only 25.6% of men and 20.8% of women received secondary prevention. Receipt of secondary prevention did not vary by socioeconomic circumstances or by sex. However, older patients were substantially less likely to receive treatment. The adjusted odds ratio for 80-89 year olds compared to 50-59 year olds was 0.53 (95% confidence interval, 0.414 to 0.89). This was because older people were less likely to receive lipid lowering drugs. Secondary prevention was associated with a 50% reduction in mortality risk. On average, mortality within the first year was 5.7% for patients receiving treatment compared with 1.1% for patients not receiving treatment. There was little evidence that the effect of treatment differed between the social groups examined. Under-treatment in older people with stroke in routine primary care cannot be justified, given the lack of evidence on variations in effectiveness of treatment by age. (RH). |
| Accession Number | CPA-090528202 A |
| Classmark | CQA: F:W: LLD: LN: L5: 3J * |
Data © Centre for Policy on Ageing |
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| ...from the Ageinfo database published by Centre for Policy on Ageing. |
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