Differences in initiation and discontinuation of preventive medications and use of non-pharmacological interventions after acute coronary syndrome among migrants and Danish-born
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Differences in initiation and discontinuation of preventive medications and use of non-pharmacological interventions after acute coronary syndrome among migrants and Danish-born. / Frederiksen, Hanne Winther; Zwisler, Ann-Dorthe; Johnsen, Søren Paaske; Öztürk, Buket; Lindhardt, Tove; Norredam, Marie.
I: European Heart Journal, Bind 39, Nr. 25, 2018, s. 2356-2364.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Differences in initiation and discontinuation of preventive medications and use of non-pharmacological interventions after acute coronary syndrome among migrants and Danish-born
AU - Frederiksen, Hanne Winther
AU - Zwisler, Ann-Dorthe
AU - Johnsen, Søren Paaske
AU - Öztürk, Buket
AU - Lindhardt, Tove
AU - Norredam, Marie
PY - 2018
Y1 - 2018
N2 - Aims The aim of this article is to assess initiation and discontinuation of preventive medication and use of non-pharmacological prevention interventions after acute coronary syndrome (ACS) among migrants to Denmark compared to the local-born Danish population, taking differences in comorbidity and sociodemographic factors into account. Methods and results In this large cohort study, we selected the population (n = 33 199) from nationwide registers and followed each individual among migrants and Danish-born 180 days after ACS. We identified the initiation and discontinuation of medications and the initiation and number of contacts for non-pharmacological interventions in the Register of Medicinal Products Statistics and the National Patient Register, and adjusted for comorbidity and sociodemographic factors. Non-Western migrants had lower relative risks for initiating adenosine diphosphate receptor (ADP)- and angiotensin-converting enzyme (ACE)-inhibitors (0.93, CI: 0.90; 0.96, and 0.91, CI: 0.87; 0.96) and patient education (0.95, CI: 0.92; 0.98). Further, non-Western migrants had higher hazard ratios for discontinuing medications (statins: 1.64, CI: 1.45; 1.86, ADP-inhibitors: 1.72, CI: 1.50; 1.97, β-blockers: 1.52, CI: 1.40; 1.64, and ACE-inhibitors: 1.72, CI: 1.46; 2.02), and fewer contacts for physical exercise and patient education (P < 0.001 and P = 0.011). Conclusion We identified differences between non-Western migrants and Danish-born in initiation and discontinuation of preventive medications and use of non-pharmacological interventions after ACS. These differences could not be explained by differences in comorbidity or sociodemographic factors.
AB - Aims The aim of this article is to assess initiation and discontinuation of preventive medication and use of non-pharmacological prevention interventions after acute coronary syndrome (ACS) among migrants to Denmark compared to the local-born Danish population, taking differences in comorbidity and sociodemographic factors into account. Methods and results In this large cohort study, we selected the population (n = 33 199) from nationwide registers and followed each individual among migrants and Danish-born 180 days after ACS. We identified the initiation and discontinuation of medications and the initiation and number of contacts for non-pharmacological interventions in the Register of Medicinal Products Statistics and the National Patient Register, and adjusted for comorbidity and sociodemographic factors. Non-Western migrants had lower relative risks for initiating adenosine diphosphate receptor (ADP)- and angiotensin-converting enzyme (ACE)-inhibitors (0.93, CI: 0.90; 0.96, and 0.91, CI: 0.87; 0.96) and patient education (0.95, CI: 0.92; 0.98). Further, non-Western migrants had higher hazard ratios for discontinuing medications (statins: 1.64, CI: 1.45; 1.86, ADP-inhibitors: 1.72, CI: 1.50; 1.97, β-blockers: 1.52, CI: 1.40; 1.64, and ACE-inhibitors: 1.72, CI: 1.46; 2.02), and fewer contacts for physical exercise and patient education (P < 0.001 and P = 0.011). Conclusion We identified differences between non-Western migrants and Danish-born in initiation and discontinuation of preventive medications and use of non-pharmacological interventions after ACS. These differences could not be explained by differences in comorbidity or sociodemographic factors.
KW - Secondary prevention
KW - Migrants
KW - Acute coronary syndrome
KW - Equity of care
KW - Register studies
U2 - 10.1093/eurheartj/ehy227
DO - 10.1093/eurheartj/ehy227
M3 - Journal article
C2 - 29718168
VL - 39
SP - 2356
EP - 2364
JO - European Heart Journal
JF - European Heart Journal
SN - 0195-668X
IS - 25
ER -
ID: 209290310