European Heart Journal
Volume 39, Issue 25, 2018, Pages 2356-2364

Differences in initiation and discontinuation of preventive medications and use of non-pharmacological interventions after acute coronary syndrome among migrants and Danish-born (Article) (Open Access)

Frederiksen H.W.* , Zwisler A.-D. , Johnsen S.P. , Öztürk B. , Lindhardt T. , Norredam M.
  • a Department of Internal Medicine, Copenhagen University Hospital, Herlev, Herlev ringvej 75, Herlev, DK-2730, Denmark, Danish Research Centre for Migration, Ethnicity and Health, Section of Health Services Research, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Building 10, Copenhagen, DK-1014, Denmark, University College Capital, Humletorvet 3, København V, DK-1799, Denmark
  • b Danish Knowledge Centre for Rehabilitation and Palliative Care, University of Southern Denmark, Vestergade 17, Nyborg, DK-5800, Denmark, Odense University Hospital, Odense, Denmark
  • c Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, Aarhus N, DK-8200, Denmark
  • d Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, Aarhus N, DK-8200, Denmark
  • e Department of Internal Medicine, Copenhagen University Hospital, Herlev, Herlev ringvej 75, Herlev, DK-2730, Denmark
  • f Danish Research Centre for Migration, Ethnicity and Health, Section of Health Services Research, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Building 10, Copenhagen, DK-1014, Denmark

Abstract

Aims The aim of this article is to assess initiation and discontinuation of preventive medication and use of non-pharmacological prevention interventions after acute coronary syndrome (ACS) among migrants to Denmark compared to the local-born Danish population, taking differences in comorbidity and sociodemographic factors into account. Methods In this large cohort study, we selected the population (n = 33 199) from nationwide registers and followed each in- and results dividual among migrants and Danish-born 180 days after ACS. We identified the initiation and discontinuation of medications and the initiation and number of contacts for non-pharmacological interventions in the Register of Medicinal Products Statistics and the National Patient Register, and adjusted for comorbidity and sociodemographic factors. Non-Western migrants had lower relative risks for initiating adenosine diphosphate receptor (ADP)- and angiotensin-converting enzyme (ACE)-inhibitors (0.93, CI: 0.90; 0.96, and 0.91, CI: 0.87; 0.96) and patient education (0.95, CI: 0.92; 0.98). Further, non-Western migrants had higher hazard ratios for discontinuing medications (statins: 1.64, CI: 1.45; 1.86, ADP-inhibitors: 1.72, CI: 1.50; 1.97, b-blockers: 1.52, CI: 1.40; 1.64, and ACE-inhibitors: 1.72, CI: 1.46; 2.02), and fewer contacts for physical exercise and patient education (P < 0.001 and P = 0.011).Conclusion We identified differences between non-Western migrants and Danish-born in initiation and discontinuation of preventive medications and use of non-pharmacological interventions after ACS. These differences could not be explained by differences in comorbidity or sociodemographic factors. © The Author(s)2018 All rights reserved.

Author Keywords

Migrants • Acute coronary syndrome Secondary prevention Register studies Equity of care

Index Keywords

demography exercise human comorbidity controlled study priority journal Aged social status migrant ethnic difference Danish citizen male female unclassified drug high risk population Article patient education adenosine receptor blocking agent hydroxymethylglutaryl coenzyme A reductase inhibitor adenosine diphosphate receptor inhibtor patient compliance major clinical study adult dipeptidyl carboxypeptidase inhibitor drug withdrawal low risk population acute coronary syndrome cohort analysis
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85050581971&doi=10.1093%2feurheartj%2fehy227&partnerID=40&md5=0599fcbc190c99118af9ee50fac05d7f
DOI: 10.1093/eurheartj/ehy227
ISSN: 0195668X
Cited by: 4
Original Language: English