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Social stratification in the dissemination of statins after stroke in Sweden

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

Since 2005, statins have been recommended to patients with ischaemic stroke. The objective of this study was to analyse how statin treatment has been disseminated in different patient groups (age, sex, socioeconomic status and country of birth) in Sweden between 2004 and 2009.

Methods

The Swedish Stroke Register (Riks-Stroke) has been linked to the Longitudinal Integration Database for Health Insurance and Labour Market Studies. Approximately 85 % of stroke patients in Sweden are included in Riks-Stroke. Odds ratios for statin prescribing were calculated using a multivariable logistic regression model including age, sex, socioeconomic status and risk factors.

Results

During the study period, 108,950 ischaemic stroke patients were discharged alive from hospital. The proportion with statins at discharge increased from 32.9 % in 2004 to 60.1 % in 2009. Patients with secondary school or university education had slightly higher odds [odds ratio (OR) 1.07, 95 % confidence interval (CI) 1.04–1.11 and OR 1.05, 95 % CI 1.01–1.10 respectively] than patients with primary school education. Patients on a high income were prescribed more statins than those on a low income (OR 1.24, 95 % CI 1.19–1.28). Compared with patients born in Sweden, patients born in other countries were prescribed more statins (Nordic countries excepting Sweden: OR 1.07, 95 % CI 1.01–1.14; Europe: OR 1.31, 95 % CI 1.22–1.40; Outside Europe: OR 1.20, 95 % CI 1.08–1.34).

Conclusions

Statin prescribing after ischaemic stroke has increased from 2004 to 2009. Our results also show a social stratification in the dissemination of statins, with patients having a higher income and patients with higher education receiving statins more often than those with a lower income and education, and patients born in Sweden receiving statins less often than those born outside of Sweden.

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Acknowledgments

The authors would like to thank Riks-Stroke for providing the database and Prof. Rune Dahlqvist for his comments on the manuscript.

Sources of funding

Riks-Stroke, the Swedish Stroke Register, is funded by the National Board of Health and Welfare and the Swedish Association of Local Authorities and Regions. This study was supported by the VINNVÅRD research programme, the Swedish Council for Working Life and Social Research (FAS), and the Swedish Research Council.

Disclosures

None.

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Authors and Affiliations

  1. Department of Pharmacology and Clinical Neuroscience, Umeå University, 901 87, Umeå, Sweden

    Maria Sjölander

  2. Department of Statistics, Umeå School of Business and Economics, Umeå University, Umeå, Sweden

    Marie Eriksson

  3. Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden

    Eva-Lotta Glader

Authors
  1. Maria Sjölander
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  2. Marie Eriksson
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  3. Eva-Lotta Glader
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Corresponding author

Correspondence to Maria Sjölander.

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Sjölander, M., Eriksson, M. & Glader, EL. Social stratification in the dissemination of statins after stroke in Sweden. Eur J Clin Pharmacol 69, 1173–1180 (2013). https://doi.org/10.1007/s00228-012-1454-8

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  • DOI: https://doi.org/10.1007/s00228-012-1454-8

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