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Published on: November 10, 2017

Racial differences in lipid-lowering agent use in medicaid patients with cardiovascular disease

David Litaker1, Siran M Koroukian

  • 1Department of Medicine, Case Western Reserve University, Cleveland, Ohio 44106, USA. dxl25@po.cwru.edu

Medical Care
|September 21, 2004
PubMed

Insights

Minorities with cardiovascular disease (CVD) are less likely to use lipid-lowering agents (LLAs) due to underuse before and after diagnosis. Targeted strategies are needed to reduce disparities in CVD preventive care.

Area of Science:

  • Cardiovascular Medicine
  • Health Disparities Research
  • Pharmacotherapy Outcomes

Background:

  • Racial disparities in cardiovascular disease (CVD) outcomes are established, but the role of preventive care processes remains unclear.
  • Understanding preventive care utilization is crucial for addressing unequal CVD outcomes.

Purpose of the Study:

  • To investigate the association between race and the use of lipid-lowering agents (LLAs) among individuals with incident CVD.
  • To examine prior LLA use, initiation of LLAs, and discontinuation of LLAs in relation to race.

Main Methods:

  • Retrospective analysis of fee-for-service Medicaid claims data from 1993-1998.
  • Included continuously enrolled individuals under 65 with a new CVD diagnosis (n=14,833).
  • Assessed LLA pharmacy claims for 24 months around the CVD event; multivariable logistic regression controlled for covariates.

Main Results:

  • Minority individuals were less likely to have prior LLA use (aOR=0.64), initiate new prescriptions (aOR=0.62), or continue LLA therapy (aOR=0.74).
  • Overall, 26.4% of individuals used LLAs, with 78.6% of users obtaining refills.

Conclusions:

  • Publicly insured minorities with prescription coverage experience less benefit from CVD preventive care, including LLAs.
  • Provider-initiated underprescription and patient-initiated discontinuation contribute to LLA underuse among minorities.
  • Strategies targeting LLA underuse across the care continuum are essential to mitigate CVD outcome disparities.
Abstract

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