Document Detail


Do immigrants from Turkey, Pakistan and Yugoslavia receive adequate medical treatment with beta-blockers and statins after acute myocardial infarction compared with Danish-born residents? A register-based follow-up study.
MedLine Citation:
PMID:  20393695     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: We undertook a study investigating whether immigrants from Turkey, Pakistan and Yugoslavia received adequate medical treatment with beta-blockers and statins after acute myocardial infarction (AMI) when compared with Danish-born residents and explored whether associations between patient origin and medical treatment were mediated by socioeconomic status (SES). METHODS: This register-based follow-up study consisted of individuals >17 years of age, admitted to hospital with AMI between 2001 and 2005 (n=25,443). Danish-born residents were compared with immigrants from Turkey, Pakistan and Yugoslavia. Individuals were identified by civil registration number, and data were obtained through linkage to the national registers of hospitalisations and drug prescriptions. Odds of initiating treatment and hazard ratios (HR) of terminating treatment were estimated. Mediators such as income and employment were included in the models. RESULTS: Pakistanis were less likely than Danish-born residents to initiate treatment with beta-blockers after AMI [odds ratio 0.52; 95% confidence interval (CI) 0.34-0.80]. Immigrants from Turkey (HR 1.36; 95% CI 1.07-1.73) and Pakistan (HR 1.59; 95% CI 1.21-2.08) were more likely to terminate treatment with beta-blockers before being recommended to do so. Estimates did not change markedly when income and education were included in the models. CONCLUSIONS: The results of this study suggest that immigrants from Pakistan and Turkey do not receive adequate medical treatment with beta-blockers after a first AMI compared with Danish-born residents. Mediators such as income and employment may not be sufficient indicators of SES when the effect of patient origin on medical treatment is explored. A lower SES of immigrants, communication problems between doctor and patient and doctors' attitudes towards immigrants may explain ethnic differences in medical treatment after AMI.
Authors:
Nana Folmann Hempler; Finn Diderichsen; Finn Breinholt Larsen; Steen Ladelund; Torben Jørgensen
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of clinical pharmacology     Volume:  66     ISSN:  1432-1041     ISO Abbreviation:  Eur. J. Clin. Pharmacol.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-17     Completed Date:  2010-09-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1256165     Medline TA:  Eur J Clin Pharmacol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  735-42     Citation Subset:  IM    
Affiliation:
Research Centre for Prevention and Health, Capital Region of Denmark, Glostrup University Hospital, Building 84/85, DK-2600 Glostrup, Denmark. nabf@glo.regionh.dk
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adolescent
Adrenergic beta-Antagonists / therapeutic use*
Adult
Denmark
Emigrants and Immigrants*
Female
Follow-Up Studies
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
Male
Medication Adherence
Middle Aged
Models, Statistical
Myocardial Infarction / drug therapy*,  ethnology*
Pakistan / ethnology
Social Class
Turkey / ethnology
Yugoslavia / ethnology
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors

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