Patient and Physician Sex Differences in Cardiovascular Risk Factor Management Using Multiple Level Regression Models
| Management | Female vs Male Patient OR (95% CI) | Female vs Male Physician OR (95% CI) |
|---|---|---|
| ACE=angiotensin-converting enzyme; CI=confidence interval; OR = odds ratio. | ||
| Note: Adjusted for patients’ variables: age (<55 vs 55+ years), body mass index, education, marital status, type of medical insurance, on medication for the condition (lipid disorder, hypertension, diabetes mellitus), cerebrovascular disease risk. | ||
| Physicians’ variables: sex, specialty (family medicine vs internal medicine), medical school graduation (US vs other), number of patients per day, (1–20/d vs >20/d), number of hours per week in patient care (more or less than 40 h/wk), number of years in the practice (more or fewer than 16 years). | ||
| Practice variables: practice size (small vs large), practices with or without physicians’ assistants. | ||
| Intracluster coefficients: lipid management, lipid-lowering medication, 0.10; hypertension management, blood pressure control, 0.08; dietary advice, 0.24; blood pressure medication, 0.04; weight loss-diet advice, 0.18; physical activity advice, 0.28; diabetes mellitus management, dietary advice, 0.21, glucose-lowering medication, 0.04, physical activity advice, 0.36, aspirin therapy, 0.10. | ||
| Lipid management | ||
| Suggest medication | 0.75 (0.56–1.02) | 1.03 (0.69– 1.52) |
| Hypertension management | ||
| Blood pressure <140/90 mm Hg | 0.61 (0.36–1.03) | 1.61 (0.90– 2.89) |
| Advice for diet and weight loss | 1.05 ( 0.65–1.71) | 2.22 (1.12–4.40) |
| On blood pressure medication | 0.84 ( 0.55–1.27) | 1.98 (1.19–3.29) |
| Weight management | ||
| Advice for diet and weight loss | 0.93 (0.66–1.31) | 2.14 (1.30–3.51) |
| Physical activity advice | 1.00 (0.74–1.34) | 2.03 (1.3–3.18) |
| Diabetes management | ||
| Advice for diet and weight loss | 2.58 ( 0.90–7.39) | 2.25 (0.50–10.22) |
| Physical activity advice | 1.16 ( 0.55–2.48) | 6.55 (2.01–21.33) |
| Diabetes medication | 0.49 (0.25–0.94) | 0.76 ( 0.35–1.67) |
| Aspirin therapy | 0.30 (0.15–0.58) | 0.69 (0.30–1.57) |
| ACE inhibitor therapy | 0.39 (0.22–0.72) | 0.82 (0.41–1.64) |