Key result
Female gender reduced (OR 0.53; 95% CI 0.32-0.87) and adequately controlled cholesterol increased (OR 1.82; 95% CI 1.18-2.80) the likelihood of enrollment in an IHD secondary prevention programme.
Why the study?
What factors are associated with participation in a secondary prevention programme for ischemic heart disease?
Cohort (n=493)
Yes
What factors are associated with participation in a secondary prevention programme for ischemic heart disease?
Enrollment in secondary prevention programs for IHD in general practice may be subject to selection bias, favoring men and those with well-managed cholesterol.
Answers are grounded in this paper and cite their sources.
May signal selection bias in IHD secondary prevention enrollment; leaves open whether outreach improves equity for women and uncontrolled-cholesterol patients.
OBJECTIVE: To evaluate differences between adults who participated in a secondary prevention of ischaemic heart disease (IHD) programme and those who did not. DESIGN: Population-based cohort study. SETTING: A random selection of 12 Irish general practices. PARTICIPANTS: A total of 493 adults with IHD identified in 2000/2001. INTERVENTION: Medical records search and postal questionnaires in 2000/2001 and 2005/2006. MAIN OUTCOME MEASURES: Differences in demographic characteristics and indicators of process of care and risk factor management between participants and non-participants. RESULTS: Multiple logistic regression confirmed that female gender was associated with a reduced likelihood of participation in the secondary prevention programme [odds ratio (OR) 0.53 (95% CI: 0.32-0.87)], while an adequately controlled total cholesterol level was associated with an increased likelihood of enrollment [OR 1.82 (95% CI: 1.18-2.80)]. CONCLUSIONS: There is limited evidence that biases, which have been shown to affect participation in research, also affect participation in care programmes in everyday practice. A gender bias appears to have affected the enrollment of participants for the secondary preventive programme considered by this study, with enrollment favouring men with well-managed cholesterol. Reimbursement dependent upon patient adherence may incentivise the enrollment of adherent patients, although the influence of patient choice is unclear: the need to maintain records relating to patients who opt out of such interventions is thus highlighted.
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Buckley et al. (2007) conducted a cohort in Ischaemic heart disease (IHD) (n=493). Female gender and adequately controlled total cholesterol vs. Male gender and inadequately controlled cholesterol was evaluated on Participation in the secondary prevention programme (OR 0.53, 95% CI 0.32-0.87). Female gender reduced (OR 0.53; 95% CI 0.32-0.87) and adequately controlled cholesterol increased (OR 1.82; 95% CI 1.18-2.80) the likelihood of enrollment in an IHD secondary prevention programme.
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