Totally incomplete research. Nothing on why women don't follow instructions, it's simple; ask them. If you can't do good research, get the hell out!
GDMT Prescription, Adherence Less Likely After Stroke in Women vs Men
At 1 year after index hospitalization, women vs men with
stroke were more likely to have nonadherence to statins,
antihypertensives, and a combination of the 2 medications.
Guideline-directed medical therapy (GDMT) is less likely after hospitalization for an ischemic stroke in women vs men. Moreover, women are more likely to not adhere to these medications. These are the findings of a study published in the journal Stroke.
Although previous studies have shown sex-specific differences in medication adherence among patients with chronic diseases, limited data are available on GDMT adherence in men vs women after a stroke.
Therefore, researchers of a retrospective cohort analysis compared prescription patterns for GDMT after hospitalization and medication adherence to GDMT 1 year after a stroke, and identified predictors of medication nonadherence to GDMT.
The researchers identified adult participants, with hospitalization after an acute ischemic stroke or transient ischemic attack (TIA), from a claims database between 2016 and 2020. In addition, only participants who were “new users” of GDMT medications were included in the study.
Treatment initiation of GDMT was considered as the index date.
Primary study outcome was sex differences in GDMT initiation, defined as filling of a new prescription for statins, antihypertensives, and oral anticoagulants, within 30 days of discharge from hospital. Secondary outcome was sex differences in GDMT adherence, defined by proportion of days covered (PDC).
A total of 15,919 patients (women, 48.3%) with hospitalization of ischemic stroke/TIA who were initiated on GDMT were included in the analysis. The most common comorbidities were hypertension (48.7%), hyperlipidemia (30.1%), and diabetes (14.6%).
Compared with men, women were younger (56.3 vs 55.2 years) and had a lower prevalence of comorbidities, including hypertension (61.5% vs 50.9%) and diabetes (20.1% vs 14.9%, respectively).
Of the total cohort, 10,302 (64.7%) were initiated on statins and 5501 (34.6%) on antihypertensives, as well as oral anticoagulants for patients with atrial fibrillation, within 30 days of discharge. Overall, women vs men were less likely to receive statins (58.0% vs 71.8%), high-potency statins (39.7% vs 53.6%), oral anticoagulants (41.2% vs 45.0%), and antihypertensives (27.7% vs 41.8%, respectively). Results were consistent within 60 days of discharge, as well.
At 1 year after index hospitalization, women vs men were more likely to have nonadherence (PDC <0.80) to statins (47.3% vs 41.6%; P <.0001), antihypertensives (33.3% vs 32.2%; P =.01), and a combination of the 2 medications (49.6% vs 45.0%; P =.006, respectively).
In a multivariable analysis, the researchers found that women vs men had a higher likelihood of nonadherence to statins and antihypertensives at 1 year (odds ratio [OR], 1.23; 95% CI, 1.08-1.41). Of note, older age predicted increased risk for nonadherence (OR, 0.98; 95% CI, 0.97-0.99).
Limitations of the analysis included the retrospective design; lack of complete information on demographic characteristics, such as race; and diagnoses of acute ischemic stroke based on the International Classification of Diseases (ICD) codes, which may have led to misclassification.
“The unique barriers facing women with regard to receiving evidence-based, guideline-recommended care should be characterized. Such information is critically important for the development of novel interventions designed to address and minimize these disparities,” the researchers concluded.
Multiple study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of the authors’ disclosures.
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