Are doctors using more preventive medication for cardiovascular disease? A Swedish cross-sectional study

Area of Science:

• Cardiovascular medicine
• Health services research
• Medical ethics

Background:

• Cardiovascular disease (CVD) mortality shows persistent inequities across socioeconomic groups.
• Primary preventative medications are crucial for reducing CVD mortality.
• Physician prescribing bias may exacerbate these health disparities.

Purpose of the Study:

• To investigate whether primary cardiovascular disease (CVD) preventative medications are prescribed inequitably between physicians and non-physicians.
• To identify potential disparities in access to essential CVD prevention treatments.

Main Methods:

• Retrospective analysis of Swedish registry data for physicians and matched non-physicians (aged 45-74) in 2013.
• Used myocardial infarction (MI) prevalence as a proxy for medication need, excluding individuals with diagnosed CVD or diabetes.
• Employed conditional logistic regression to estimate odds ratios (ORs) for medication use, adjusting for need and income.

Main Results:

• The study included 25,105 physicians and 44,366 non-physicians.
• Physicians had a 65% higher likelihood (OR 1.65) of receiving CVD preventative medication compared to non-physicians.
• Prevalence of MI was similar between physicians and non-physicians, suggesting need did not fully explain the difference.

Conclusions:

• An inequity in the prescription of preventative cardiovascular disease (CVD) medications was identified, favoring physicians.
• These findings suggest potential physician self-prescribing bias contributing to health disparities in CVD prevention.
• Addressing prescribing patterns is essential for ensuring equitable access to CVD preventative care.