Racial differences in statin adherence following hospital discharge for ischemic stroke.

Academic Article

Abstract

  • OBJECTIVE: To compare nonadherence to statins in older black and white adults following an ischemic stroke. METHODS: We studied black and white adults ≥66 years of age with Medicare fee-for-service insurance coverage hospitalized for ischemic stroke from 2007 to 2012 who filled a statin prescription within 30 days following discharge. Nonadherence was defined as a proportion of days covered <80% in the 365 days following hospital discharge. In addition, we evaluated factors associated with nonadherence for white and black participants separately. RESULTS: Overall 2,763 beneficiaries met the inclusion criteria (13.5% black). Black adults were more likely than white adults to be nonadherent (49.7% vs 41.5%) even after adjustment for demographics, receipt of a low-income subsidy, and baseline comorbidities (adjusted relative risk [RR] 1.14, 95% confidence interval [CI] 1.01-1.29). Among white adults, receipt of a low-income subsidy (adjusted RR 1.13, 95% CI 1.02-1.26), history of coronary heart disease (adjusted RR 1.15, 95% CI 1.01-1.30), and discharge directly home following stroke hospitalization (adjusted RR 1.26, 95% CI 1.10-1.44) were associated with a higher risk of nonadherence. Among black adults, a 1-unit increase in the Charlson comorbidity index (adjusted RR 1.04, 95% CI 1.01-1.09), history of carotid artery disease (adjusted RR 2.38, 95% CI 1.08-5.25), and hospitalization during the 365 days prior to the index stroke (adjusted RR 1.34, 95% CI 1.01-1.78) were associated with nonadherence. CONCLUSIONS: Compared with white adults, black adults were more likely to be nonadherent to statins following hospitalization for ischemic stroke.
  • Published In

  • Neurology  Journal
  • Keywords

  • African Americans, Aged, Brain Ischemia, Carotid Artery Diseases, Comorbidity, Coronary Disease, European Continental Ancestry Group, Female, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Male, Medicare, Medication Adherence, Patient Discharge, Retrospective Studies, Risk Factors, Self Report, Socioeconomic Factors, Stroke, United States
  • Digital Object Identifier (doi)

    Author List

  • Albright KC; Zhao H; Blackburn J; Limdi NA; Beasley TM; Howard G; Bittner V; Howard VJ; Muntner P
  • Start Page

  • 1839
  • End Page

  • 1848
  • Volume

  • 88
  • Issue

  • 19