title: Socioeconomic deprivation does not affect prescribing of secondary prevention in patients with peripheral arterial disease.
abstract: OBJECTIVE
  Aim of the study was to assess the effect of socioeconomic deprivation on prescribing of cardiovascular secondary prevention medications in patients referred with peripheral arterial disease (PAD).
  
  
  METHODS
  A retrospective review of vascular clinic referrals was performed. All patients referred from primary care with suspected PAD over a two month period were included. The deprivation score, prescription of cardiovascular secondary prevention medications, smoking status and the presence of cardiovascular co-morbidities (coronary artery or cerebrovascular disease--CAD/CVD) were assessed. Comparison was made between socioeconomic groups using the Carstairs Deprivation (DepCat) Score and between patients with and without a history of currently existing cardiovascular co-morbidities.
  
  
  RESULTS
  The study included 391 patients. Almost two thirds of patients (253) were from the most deprived socioeconomic groups and were significantly younger at presentation (median age DepCat 7: 63 yrs, DepCat 1-2: 74.5 yrs, P<0.0001). The majority of patients with a prior history of CAD/CVD were prescribed secondary preventative medications at the time of referral with suspected PAD whereas those with no prior history of CAD/CVD, (212 patients, 54%) were significantly less likely to be prescribed antiplatelets (47% vs. 83%), statins (45% vs. 86%) or ACEi/ARBs (29% vs. 68%) (all P<0.05). Secondary prevention prescribing did not differ between socioeconomic groups.
  
  
  CONCLUSIONS
  Secondary prevention prescribing is inadequate in patients with suspected PAD regardless of socioeconomic group and is significantly lower in those without previously diagnosed CAD/CVD. There remains a lack of appreciation of the high cardiovascular risk associated with PAD.
authors.affiliation: Peripheral Vascular Unit, Western Infirmary, Glasgow, UK - mariac.ruiz@nhs.net.
authors.forename: J H
authors.initials: JH
authors.lastname: Park
authors.forename: M C
authors.initials: MC
authors.lastname: Ruiz
authors.forename: D
authors.initials: D
authors.lastname: Shields
authors.forename: D J
authors.initials: DJ
authors.lastname: Orr
mesh_terms: D000368:Aged; D002317:Cardiovascular Agents / Q000191:economics / Q000627:therapeutic use*; D015897:Comorbidity; D011307:Drug Prescriptions; D017723:Drug Utilization Review / Q000639:trends; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D011203:Poverty; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000639:trends*; D012017:Referral and Consultation; D012189:Retrospective Studies; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D055502:Secondary Prevention / Q000191:economics / Q000639:trends*; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D012923:Social Class; D012959:Socioeconomic Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents