| アブストラクト | BACKGROUND: This observational study using the national US Medicare claim databases aimed to examine the association of patient and physician sex with statin discontinuation. METHODS: We used data on a 20% random sample of Medicare fee-for-service beneficiaries aged 66-99 years who initiated statins for primary prevention (absence of the historical diagnosis of myocardial infarction, ischemic heart disease, stroke, transient ischemic attack, and peripheral vascular disease) from January 2017 to June 2019. The primary outcome was early discontinuation (defined as the lack of second dispense at year 1), adjusting for patient demographics, comorbidities, concomitant medications, and physicians' age and specialty. RESULTS: Of 423,404 patients who initiated statins, 43,053 (10.2%) experienced early discontinuations. The adjusted risk of early discontinuation was similar but slightly lower when initiated by female physicians at 9.9% [95% confidence interval (CI), 9.1 to 10.6] versus male physicians at 10.3% (95% CI, 9.6 to 11.0) with an adjusted risk difference (aRD) of -0.4 percentage-points (pp) (95% CI, -0.7 to -0.2; p < 0.001). When stratified by patient sex, the findings were similar in both female patients (aRD, -0.5 pp.; 95% CI, -0.7 to -0.2; p < 0.001) and male patients (-0.5 pp.; 95% CI, -0.8 to -0.1; p = 0.007). The findings were consistent regardless of the diabetes status or the intensity of statins. CONCLUSION: Using the nationwide administrative databases, we found that both older female and male patients were slightly less likely to experience early discontinuation of statins when prescribed by female versus male physicians, though the differences were clinically small. |
|---|
| 投稿者 | Watanabe, Atsuyuki; Miyamoto, Yoshihisa; Ueyama, Hiroki A; Gotanda, Hiroshi; Slipczuk, Leandro; Inoue, Kosuke; Secemsky, Eric; Laham, Roger; Bhatt, Deepak L; Tsugawa, Yusuke; Kuno, Toshiki |
|---|
| 組織名 | Department of Medicine, Mount Sinai Morningside and West, Icahn School of;Medicine at Mount Sinai, New York, NY, USA.;Department of Real-world Evidence, The University of Tokyo, Tokyo, Japan.;Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA.;Division of General Internal Medicine, Cedars-Sinai Medical Center, Los Angeles,;CA, USA.;Division of Cardiology, Montefiore Health System/Albert Einstein College of;Medicine, Bronx, NY, USA.;Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess;Medical Center, Boston, MA, USA; Department of Social Epidemiology, Graduate;School of Medicine, Kyoto University, Kyoto, Japan.;Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical;School, Boston, MA, USA.;Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New;York, NY, USA.;Division of General Internal Medicine and Health Services Research, David Geffen;School of Medicine at The University of California, Los Angeles, CA, USA;;Department of Health Policy and Management, UCLA Fielding School of Public;Health, Los Angeles, CA, USA.;School, Boston, MA, USA; Cardiology Division, Massachusetts General Hospital,;Harvard Medical School, Boston, MA, USA. Electronic address:;tkuno@bidmc.harvard.edu. |
|---|
