Curriculum in CardiologyGender and racial disparities in adherence to statin therapy: A meta-analysis
Section snippets
Methods
We performed an electronic search of Medline, EMBASE, ClinicalTrials.gov, and the Cochrane Database of Systematic Reviews through April 1, 2010, for studies that reported adherence to statins.
Results
Our search identified 3,022 unique abstracts, of which 53 studies met our inclusion criteria (Figure 1). These studies included a total of 2,663,638 patients (sample size range 83-962,877), and average adherence in all studies was 48%. Among the 53 included studies, 51 evaluated adherence based on gender8, 9, 17, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64,
Discussion
Racial and gender-based disparities in cardiovascular outcomes have been well described. The reasons for these differences in care are complex, but differences have been documented in the use of invasive cardiovascular procedures as a result of patient preference, greater diagnostic and therapeutic uncertainty, stereotyping, and bias.69 Evidence-based medications, including statins, are a cornerstone of cardiovascular risk reduction, and therefore, disparities in their use may also be
Disclosures
Dr Choudhry is a consultant to Mercer Health and Benefits, Inc. Dr Shrank is a consultant on research methodology to United Healthcare. Dr Brennan is an employee of CVS Caremark.
Acknowledgements
The authors thank Jessica Myers, PhD, for statistical expertise.
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