Immigration status and utilization of secondary preventive treatment after ischemic stroke

Posted on 12.07.2022 - 00:10
Introduction:

The objective of the study was to assess use and persistence of secondary preventive treatment after ischemic stroke comparing immigrants and Danish-born residents.

Patients and methods:

A cohort of patients discharged with ischemic stroke (IS) diagnosis (n = 106,224) by immigration status was identified from the Danish Stroke Registry between 2005 and 2018. We investigated use (claiming at least one prescription in 180 days post-discharge according to information from the Register of Medicinal Products Statistics) and persistence of treatment within 180 days thereafter using multivariable logistic regression and Fine and Gray models.

Results:

Overall, 82,078 Danish-born residents (80.6%) and 3589 (80.7%) immigrants with IS used at least one of the recommended preventive medications post-discharge. Immigrants had lower odds of use of anticoagulants and angiotensin-converting enzyme (ACE) inhibitors/angiotensin II receptor blockers (ARB) (odds ratio (OR), 0.66; 95% confidence interval (CI), 0.53–0.82 and OR, 0.87; 95% CI, 0.75–0.98, respectively) but had higher odds of use of beta-blockers (OR, 1.25; 95% CI, 1.02–1.53) than Danish-born residents after adjustment for age at stroke, sex, sociodemographic factors, duration of residence, stroke severity, and comorbidities. The odds were most evident among immigrants originating from non-Western countries. Persistence of medication use did not differ between immigrants and Danish-born residents after adjustment for sociodemographic factors and comorbidities.

Conclusion:

Modest disparities in use of standard guideline recommended secondary preventive medications were observed when comparing immigrants and Danish-born residents with ischemic stroke. Furthermore, no differences in persistence of medication therapy were observed.

CITE THIS COLLECTION

Mkoma, George F; Johnsen, Søren P; Iversen, Helle K; Andersen, Grethe; Norredam, Marie (2022): Immigration status and utilization of secondary preventive treatment after ischemic stroke. SAGE Journals. Collection. https://doi.org/10.25384/SAGE.c.6089632.v1
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European Stroke Journal

AUTHORS (5)

George F Mkoma
Søren P Johnsen
Helle K Iversen
Grethe Andersen
Marie Norredam
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