The use of antiplatelet agents for secondary prevention of ischemic stroke in U.S. ambulatory care settings.
BACKGROUND
We examined stroke prevention with antiplatelet agents by U.S. nonfederal office physicians and hospital outpatient departments from 2005-2006.


METHODS
The nationally representative dataset used a multistage (112 primary sampling units, physicians/ hospitals, patient medical records) random sample of 1,702 visits by patients 20 years or older with cerebrovascular disease (national estimate: 15.4 million annual visits). Dependent variable: use of antiplatelet agents for patients without contraindications.


METHODS
age, sex, race/ethnicity, payment, primary care provider, prior visits in last year, comorbidities. Logistic regression was used to investigate associations with recommended interventions.


RESULTS
Antiplatelet agents were prescribed at 31.1% of visits. Positive predictors: seeing the patient's primary care provider and having five or more comorbidities. Negative predictors: non-Hispanic Black race/ethnicity and having six or more prior visits in the last year.


CONCLUSIONS
Variations by visit characteristics suggest that improvement in using antiplatelet agents is possible, especially for non-Hispanic Black patients.
Niska
Richard
R
National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782, USA. RNiska@cdc.gov
Han
Beth
B
D000328:Adult; D000554:Ambulatory Care Facilities; D004363:Drug Utilization; D005006:Ethnicity; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010044:Outpatient Clinics, Hospital; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D020521:Stroke / Q000208:ethnology / Q000517:prevention & control*; D014481:United States; D055815:Young Adult
D010975:Platelet Aggregation Inhibitors