Document Detail


Association of race with cumulative exposure to statins in dialysis.
MedLine Citation:
PMID:  22739257     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Patients on dialysis have high rates of cardiovascular disease and are frequently treated with HMG-CoA reductase inhibitors. Given that these patients have insurance coverage for medications as well as regular contact with health care providers, differences by race in exposure to statins over time should be minimal among patients who are candidates for the drug.
METHODS: We created a cohort of incident dialysis patients who were dually eligible for Medicare and Medicaid services. We determined the proportion of days covered (or PDC, a marker of cumulative medication exposure) by a statin prescription over a mean of 2.0 ± 1.4 years. Ordinary least squares regression was used to determine the factors associated with cumulative drug exposure.
RESULTS: Of the 18,727 patients who filled at least one prescription for a statin, mean PDC was 0.57 ± 0.32. The unadjusted PDC was higher for Caucasians (0.63 ± 0.31) than for African-Americans (0.51 ± 0.32), Hispanics (0.54 ± 0.31), and individuals of other race/ethnicity (0.58 ± 0.32). In multivariable modeling, Caucasian race was independently associated with greater exposure to statins. Relative to Caucasians, the adjusted odds ratios for the PDC for African-Americans was 0.47 (95% confidence interval, CI, 0.43-0.50), for Hispanics 0.52 (0.48-0.56) and for others, 0.72 (0.64-0.81).
CONCLUSIONS: Despite insurance coverage, regular contact with health care providers, and at least one prescription for a statin, there are large differences by race in statin exposure over time. The provider- and patient-associated factors related to this phenomenon should be further examined.
Authors:
James B Wetmore; Jonathan D Mahnken; Sally K Rigler; Edward F Ellerbeck; Purna Mukhopadhyay; Qingjiang Hou; Theresa I Shireman
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-06-27
Journal Detail:
Title:  American journal of nephrology     Volume:  36     ISSN:  1421-9670     ISO Abbreviation:  Am. J. Nephrol.     Publication Date:  2012  
Date Detail:
Created Date:  2012-07-20     Completed Date:  2012-11-29     Revised Date:  2013-04-16    
Medline Journal Info:
Nlm Unique ID:  8109361     Medline TA:  Am J Nephrol     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  90-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 S. Karger AG, Basel.
Affiliation:
Division of Nephrology and Hypertension, Department of Medicine, University of Kansas School of Medicine, Kansas City, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Cardiovascular Diseases / therapy
Cohort Studies
Ethnic Groups
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
Least-Squares Analysis
Male
Medicaid
Medicare
Middle Aged
Odds Ratio
Regression Analysis
Renal Dialysis / methods*
Social Class
United States
Grant Support
ID/Acronym/Agency:
K23 DK085378-01/DK/NIDDK NIH HHS; R01 DK080111/DK/NIDDK NIH HHS; R01 DK080111-02/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Hydroxymethylglutaryl-CoA Reductase Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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