title: Social stratification in the dissemination of statins after stroke in Sweden.
abstract: OBJECTIVE
  Since 2005, statins have been recommended to patients with ischaemic stroke. The objective of this study was to analyse how statin treatment has been disseminated in different patient groups (age, sex, socioeconomic status and country of birth) in Sweden between 2004 and 2009.
  
  
  METHODS
  The Swedish Stroke Register (Riks-Stroke) has been linked to the Longitudinal Integration Database for Health Insurance and Labour Market Studies. Approximately 85 % of stroke patients in Sweden are included in Riks-Stroke. Odds ratios for statin prescribing were calculated using a multivariable logistic regression model including age, sex, socioeconomic status and risk factors.
  
  
  RESULTS
  During the study period, 108,950 ischaemic stroke patients were discharged alive from hospital. The proportion with statins at discharge increased from 32.9 % in 2004 to 60.1 % in 2009. Patients with secondary school or university education had slightly higher odds [odds ratio (OR) 1.07, 95 % confidence interval (CI) 1.04-1.11 and OR 1.05, 95 % CI 1.01-1.10 respectively] than patients with primary school education. Patients on a high income were prescribed more statins than those on a low income (OR 1.24, 95 % CI 1.19-1.28). Compared with patients born in Sweden, patients born in other countries were prescribed more statins (Nordic countries excepting Sweden: OR 1.07, 95 % CI 1.01-1.14; Europe: OR 1.31, 95 % CI 1.22-1.40; Outside Europe: OR 1.20, 95 % CI 1.08-1.34).
  
  
  CONCLUSIONS
  Statin prescribing after ischaemic stroke has increased from 2004 to 2009. Our results also show a social stratification in the dissemination of statins, with patients having a higher income and patients with higher education receiving statins more often than those with a lower income and education, and patients born in Sweden receiving statins less often than those born outside of Sweden.
authors.affiliation: Department of Pharmacology and Clinical Neuroscience, Umeå University, 901 87 Umeå, Sweden. maria.sjolander@pharm.umu.se
authors.forename: Maria
authors.initials: M
authors.lastname: Sjölander
authors.forename: Marie
authors.initials: M
authors.lastname: Eriksson
authors.forename: Eva-Lotta
authors.initials: EL
authors.lastname: Glader
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004363:Drug Utilization / Q000706:statistics & numerical data* / Q000639:trends; D005006:Ethnicity; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012042:Registries; D012727:Sex Characteristics; D012959:Socioeconomic Factors; D020521:Stroke / Q000188:drug therapy*; D013548:Sweden
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors