single PDF of the entire issue - The Royal New Zealand College of ...

More documents

Recommendations

Info

ORIGINAL SCIENTIFIC PAPERS quantitative research Table 1. Characteristics of 7622 people with a known history of CVD at first PREDICT assessment compared to characteristics of people with CVD from across Auckland/Northland Baseline characteristic Age (years) Sex Ethnicity Deprivation quintile Dispensed CVD medications Number (%) assessed by PREDICT with CVD* Number (%) across Auckland/ Northland with CVD † 35–44 306 (4%) 1411 (7%) 45–54 1319(17%) 3689 (18%) 55–64 2703 (36%) 6908 (33%) 65–74 3294 (43%) 8714 (42%) Male 4760 (63%) 12 110 (58%) Female 2862 (38%) 8612 (42%) Maori 1556 (20%) 3588 (17%) Pacific Island 1151 (15%) 2300 (11%) Indian 329 (4%) 903 (4%) European and Other 4586 (60%) 13 931 (67%) European 4249 (55%) Not available Chinese 143 (2%) Not available Other Asian 95 (1%) Not available Other 99 (1%) Not available Quintile 1: NZDep 1–2 744 (10%) 2573 (12%) Quintile 2: NZDep 3–4 968 (13%) 2942 (14%) Quintile 3: NZDep 5–6 1287(17%) 3511 (17%) Quintile 4: NZDep 7–8 1859 (24%) 4080 (20%) Quintile 5: NZDep 9–10 2750 (36%) 6334 (31%) Missing data 14 (0.2%) 1282 (6%) Blood pressure–lowering medications alone 5868 (81%) Not available Lipid-lowering medications alone 5348 (73%) Not available Both classes of medication 4860 (67%) Not available Either class of medication 6356 (87%) Not available Total number with CVD 7622 20 722 * Patients included in this study population were aged 35–74 years, with a first PREDICT assessment occurring between 1 July 2006 and 16 October 2009. † This comparison dataset comprised people from across Auckland and Northland, with an NHI number during the period 1 July 2006 to 30 June 2007 inclusive, who had a history of CVD. A history of CVD was defined by dispensing of medications commonly used to treat angina on at least two occasions between 1 July 2001 and 30 June 2007, or having a CVD-related hospital admission in the public or private sector between 1 January 1988 and 31 December 2007. Results The sociodemographic characteristics of the 7622 people who met inclusion criteria are detailed in Table 1. The age distribution closely approximates the corresponding age distribution for Auckland and Northland. Among those assessed with PREDICT, men and people of Maori and Pacific ethnicities were slightly over-represented, with Indians similarly represented. The analysis was conducted on the 7285 individuals who remained after exclusion of ‘Chinese’ (n=143), ‘Other Asian’ (n=95) and ‘Other’ (n=99) ethnic groups. Higher percentages of people from deprived quintiles were noted among the PREDICT sample, compared to the deprivation distribution across Auckland and Northland. Among people with a history of CVD recorded in PREDICT, 62% (n=4691) had suffered a coronary event, 28% (n=2103) had been diagnosed with either a stroke or TIA, and 13% (n=963) were affected by PVD. BPL medications were dispensed to 81% (n=5868), LL medications to 73% (n=5348), both BPL 96 VOLUME 3 • NUMBER 2 • JUNE 2011 J OURNAL OF PRIMARY HEALTH CARE
ORIGINAL SCIENTIFIC PAPErS quantitative research Table 2. Likelihood, according to age, of being dispensed CVD medications in the six months prior to first PREDICT assessment among people with a known history of CVD (reference group is 65–74-year-old age group) Medication category Blood pressure–lowering medications alone Lipid-lowering medications alone Both classes of medication Age group (years) Numbers (%) dispensed for each age group Sex, ethnicity and deprivation adjusted relative risks (95% CI)* 35–44 161 (56%) 0.63 (0.57–0.71) 45–54 904 (72%) 0.84 (0.81–0.87) 55–64 2106 (81%) 0.94 (0.92–0.96) 65–74 2697 (86%) 1 35–44 155 (56%) 0.70 (0.63–0.78) 45–54 855 (68%) 0.90 (0.86–0.94) 55–64 1954 (75%) 0.99 (0.96–1.02) 65–74 2384 (76%) 1 35–44 122 (42%) 0.58 (0.51–0.67) 45–54 767 (61%) 0.86 (0.82–0.91) 55–64 1759 (68%) 0.95 (0.92–0.99) 65–74 2212 (70%) 1 * Please note that the crude relative risks have not been presented as they were not appreciably different to the adjusted relative risks. and LL medications to 67% (n=4860), and 87% (n=6356) received either class of medication. Among people using BPL medications, 63% (n=3698) were dispensed ACE inhibitors, 63% (n=3695) received beta blockers, 36% (n=2122) received calcium channel blockers and 25% (n=1447) received thiazides. Statins were dispensed to 97% (n=5202) of people receiving LL medications. Tables 2, 3, 4 and 5 present the numbers and proportions of people dispensed each category of medication, and adjusted RRs with 95% CI, according to age, sex, ethnicity and deprivation. Crude RRs are not presented, as they were not appreciably different to the adjusted RRs. People aged 35–44 years were less likely to be dispensed BPL medications by 37% (RR 0.63, 95% CI 0.57–0.71), LL medications by 30% (RR 0.70, 95% CI 0.63–0.78) or both by 42% (RR 0.58, 95% CI 0.51–0.67) compared to people aged 65–74 years. For each medication category, the likelihood of dispensing increased with advancing age (Table 2). Small differences in dispensing by sex were noted. After adjustment for age, ethnicity and deprivation, women were equally likely to be dis- Table 3. Likelihood, according to sex, of being dispensed CVD medications in the six months prior to first PREDICT assessment among people with a known history of CVD (reference group is males) Medication category Blood pressure–lowering medications alone Lipid-lowering medications alone Both classes of medication Sex Numbers (%) dispensed for each sex Age, ethnicity and deprivation adjusted relative risks (95% CI)* Female 2213 (81%) 0.99 (0.97–1.01) Male 3655 (81%) 1 Female 1888 (69%) 0.91 (0.88–0.93) Male 3460 (76%) Female 1726 (63%) 0.91 (0.88–0.94) Male 3134 (69%) 1 1 * Please note that the crude relative risks have not been presented as they were not appreciably different to the adjusted relative risks. VOLUME 3 • NUMBER 2 • JUNE 2011 J OURNAL OF PRIMARY HEALTH CARE 97
Page 1: VOLUME 3 • NUMBER 2 • JUNE 2011
Page 4 and 5: EDITORIALs from the editor Morality
Page 6 and 7: EDITORIALs guest editorial The youn
Page 8 and 9: ORIGINAL SCIENTIFIC PAPERS quantita
Page 16 and 17: ORIGINAL SCIENTIFIC PAPErS quantita
Page 38 and 39: ORIGINAL SCIENTIFIC PAPERS quaLitat
Page 56 and 57: ORIGINAL SCIENTIFIC PAPERS MIXED ME
Page 58 and 59: ORIGINAL SCIENTIFIC PAPERS MIXED ME
Page 60 and 61:
ORIGINAL SCIENTIFIC PAPERS MIXED ME
Page 62 and 63:
ORIGINAL SCIENTIFIC PAPERS MIXED ME
Page 64 and 65:
improving performance (Preventing)
Page 66 and 67:
improving performance ACKNOWLEDGEME
Page 68 and 69:
improving performance All practices
Page 70 and 71:
improving performance 5. Wrong pati
Page 72 and 73:
improving performance errors that o
Page 74 and 75:
BACK TO BACK shaking would cause ne
Page 76 and 77:
BACK TO BACK The triad of retinal h
Page 78 and 79:
continuing professional development
Page 80 and 81:
Page 82 and 83:
Page 84 and 85:
ETHICS Medical ethics: four princip
Page 86 and 87:
ETHICS of his responsibility to ACC
Page 88 and 89:
ETHICS ing a case against Dr G’s
Page 90:
about the journal of primary health
show all

single PDF of the entire issue - The Royal New Zealand College of ...

Create successful ePaper yourself

Delete template?

Save as template?