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Publications (5 of 5) Show all publications
Ohlsson, A., Lindahl, B., Hanning, M. & Westerling, R. (2016). Gender inequity in heart failure treatment affects mortality in a Swedish total population cohort. European Journal of Public Health, 26
Open this publication in new window or tab >>Gender inequity in heart failure treatment affects mortality in a Swedish total population cohort
2016 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 26Article in journal (Refereed) Published
Place, publisher, year, edition, pages
OXFORD UNIV PRESS, 2016
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-321256 (URN)000398600401186 ()
Available from: 2017-05-02 Created: 2017-05-02 Last updated: 2017-05-02Bibliographically approved
Ohlsson, A., Westerling, R., Lindahl, B. & Hanning, M. (2016). Heart failure mortality in relation to unequal access to Renin-Angiotensin system blocking therapy.: A register based study.. In: : . Paper presented at Svensk Socialmedicinsk Förenings vårmöte 2016; "Jämlik hälsa-vad krävs för att nå från evidens till politik och praktik?".
Open this publication in new window or tab >>Heart failure mortality in relation to unequal access to Renin-Angiotensin system blocking therapy.: A register based study.
2016 (English)Conference paper, Poster (with or without abstract) (Other academic)
Keywords
Equity in health care, Effectiveness, Real-world research
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Social Medicine
Identifiers
urn:nbn:se:uu:diva-290464 (URN)
Conference
Svensk Socialmedicinsk Förenings vårmöte 2016; "Jämlik hälsa-vad krävs för att nå från evidens till politik och praktik?"
Available from: 2016-04-30 Created: 2016-04-30 Last updated: 2016-06-27Bibliographically approved
Ohlsson, A., Lindahl, B., Hanning, M. & Westerling, R. (2016). Inequity of access to ACE inhibitors in Swedish heart failure patients: a register-based study. Journal of Epidemiology and Community Health, 70(1), 97-103
Open this publication in new window or tab >>Inequity of access to ACE inhibitors in Swedish heart failure patients: a register-based study
2016 (English)In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 70, no 1, p. 97-103Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Several international studies suggest inequity in access to evidence-based heart failure (HF) care. Specifically, studies of ACE inhibitors (ACEIs) point to reduced ACEI access related to female sex, old age and socioeconomic position. Thus far, most studies have either been rather small, lacking diagnostic data, or lacking the possibility to account for several individual-based sociodemographic factors. Our aim was to investigate differences, which could reflect inequity in access to ACEIs based on sex, age, socioeconomic status or immigration status in Swedish patients with HF.

METHODS:

Individually linked register data for all Swedish adults hospitalised for HF in 2005-2010 (n=93,258) were analysed by multivariate regression models to assess the independent risk of female sex, high age, low employment status, low income level, low educational level or foreign country of birth, associated with lack of an ACEI dispensation within 1 year of hospitalisation. Adjustment for possible confounding was made for age, comorbidity, Angiotensin receptor blocker therapy, period and follow-up time.

RESULTS:

Analysis revealed an adjusted OR for no ACEI dispensation for women of 1.31 (95% CI 1.27 to 1.35); for the oldest patients of 2.71 (95% CI 2.53 to 2.91); and for unemployed patients of 1.59 (95% CI 1.46 to 1.73).

CONCLUSIONS:

Access to ACEI treatment was reduced in women, older patients and unemployed patients. We conclude that access to ACEIs is inequitable among Swedish patients with HF. Future studies should include clinical data, as well as mortality outcomes in different groups.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-287902 (URN)10.1136/jech-2015-205738 (DOI)26261264 (PubMedID)
Available from: 2016-04-26 Created: 2016-04-26 Last updated: 2017-08-29Bibliographically approved
Ohlsson, A., Lindahl, B., Hanning, M. & Westerling, R. (2016). Inequity of access to ACE inhibitors in Swedish heart failure patients: a register-based study. Journal of Epidemiology and Community Health, 70(1), 97-103
Open this publication in new window or tab >>Inequity of access to ACE inhibitors in Swedish heart failure patients: a register-based study
2016 (English)In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 70, no 1, p. 97-103Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Several international studies suggest inequity in access to evidence-based heart failure (HF) care. Specifically, studies of ACE inhibitors (ACEIs) point to reduced ACEI access related to female sex, old age and socioeconomic position. Thus far, most studies have either been rather small, lacking diagnostic data, or lacking the possibility to account for several individual-based sociodemographic factors. Our aim was to investigate differences, which could reflect inequity in access to ACEIs based on sex, age, socioeconomic status or immigration status in Swedish patients with HF.

METHODS: Individually linked register data for all Swedish adults hospitalised for HF in 2005-2010 (n=93 258) were analysed by multivariate regression models to assess the independent risk of female sex, high age, low employment status, low income level, low educational level or foreign country of birth, associated with lack of an ACEI dispensation within 1 year of hospitalisation. Adjustment for possible confounding was made for age, comorbidity, Angiotensin receptor blocker therapy, period and follow-up time.

RESULTS: Analysis revealed an adjusted OR for no ACEI dispensation for women of 1.31 (95% CI 1.27 to 1.35); for the oldest patients of 2.71 (95% CI 2.53 to 2.91); and for unemployed patients of 1.59 (95% CI 1.46 to 1.73).

CONCLUSIONS: Access to ACEI treatment was reduced in women, older patients and unemployed patients. We conclude that access to ACEIs is inequitable among Swedish patients with HF. Future studies should include clinical data, as well as mortality outcomes in different groups.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Social Medicine
Identifiers
urn:nbn:se:uu:diva-264530 (URN)10.1136/jech-2015-205738 (DOI)000369959800017 ()26261264 (PubMedID)
Available from: 2015-10-14 Created: 2015-10-14 Last updated: 2017-12-01Bibliographically approved
Ohlsson, A. (2015). Inequity of access to Angiotensin-converting Enzyme inhibitors in SwedishHeart failure patients. In: http://simsam.nu/wp-content/uploads/2015/03/Recap-GOCARTs-150303.pdf: . Paper presented at Social Stratification and Health March 3, 2015. Arranged by GOCARTs at the University of Gothenburg/Sahlgrenska Academy.
Open this publication in new window or tab >>Inequity of access to Angiotensin-converting Enzyme inhibitors in SwedishHeart failure patients
2015 (English)In: http://simsam.nu/wp-content/uploads/2015/03/Recap-GOCARTs-150303.pdf, 2015Conference paper, Poster (with or without abstract) (Other academic)
Abstract [en]

Background

Several international studies of Angiotensin-converting Enzyme Inhibitors (ACEIs) point to reduced ACEI access related to female sex, old age and socioeconomic position. Thus far, most studies have either been rather small; lacking diagnostic data, or lacking the possibility to account for several individual based socio-demographic factors.

Our aim was to investigate differences, which could reflect inequity, in access to ACEIs based on sex, age, socioeconomic status, or immigration status in Swedish heart failure (HF) patients.

 

Method and results

Individually-linked register data for all Swedish adults hospitalized for HF in 2005-2010 (n=93, 258) was analysed by multivariate regression models to assess the independent risk of female sex, age, low employment status, low income level, low educational level and foreign country of birth, for not being dispensed an ACEI within 1 year of hospitalization. Analysis revealed an adjusted OR for no ACEI dispensation for women of 1.31 [95% Confidence interval (CI): 1.27, 1.35]; for the oldest patients of 2.71 (95% CI: 2.53, 2.91); and for unemployed patients of 1.59 (95% CI: 1.46, 1.73). Adjustment for possible confounding was made for age, comorbidity, Angiotensin receptor blocker-therapy, period and follow-up time.

 

Conclusion

Access to ACEI treatment was reduced in women, older patients, and unemployed patients. We conclude that access to ACEIs is inequitable among Swedish HF patients.  Future studies should include clinical data, as well as mortality outcomes in different groups. 

 

Keywords: Access to Angiotensin-converting Enzyme Inhibitor (ACEI). Heart failure (HF).  Inequity. Guideline-recommended therapy. Socioeconomic position. Sex/gender.  

Keywords
Access to Angiotensin-converting Enzyme Inhibitor (ACEI). Heart failure (HF). Inequity. Guideline-recommended therapy. Socioeconomic position. Sex/gender
National Category
Medical and Health Sciences
Research subject
Medical Science; Social Medicine
Identifiers
urn:nbn:se:uu:diva-284720 (URN)
Conference
Social Stratification and Health March 3, 2015. Arranged by GOCARTs at the University of Gothenburg/Sahlgrenska Academy
Available from: 2016-04-19 Created: 2016-04-19 Last updated: 2016-06-29Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/anna.ohlsson@pubcare.uu.se

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