title: Socioeconomic Inequalities in the Prescription of Oral Anticoagulants in Stroke Patients With Atrial Fibrillation.
abstract: OBJECTIVE
  Oral anticoagulants (OACs) are effective against ischemic stroke in patients with atrial fibrillation. Our aim was to investigate differences in the prescribing of OACs after ischemic stroke in patients with atrial fibrillation based on age, sex, country of birth, and socioeconomic status.
  
  
  METHODS
  Patients with first-ever ischemic stroke and atrial fibrillation without OAC treatment were included from the Swedish stroke register from 2009 to 2012. The outcome was OAC prescribed at discharge. Income, education, country of birth, and risk factors were obtained from official registers. Risk factors and health status were controlled for in multivariable logistic regression.
  
  
  RESULTS
  Of 12 088 stroke patients, 36.3% were prescribed an OAC. Prescribing was less common with older age and, in patients born in other Nordic countries (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.68-0.98) or countries outside of Europe (OR, 0.65; 95% CI, 0.42-0.99) compared with those born in Sweden. University education (OR, 1.20; 95% CI, 1.05-1.36) and highest income (OR, 1.19; 95% CI, 1.06-1.33) were associated with higher levels of OAC prescribing compared with those with primary school education or lowest income level.
  
  
  CONCLUSIONS
  Differences by age, income, education, and country of birth were found in the prescribing of OACs after stroke. Differences were not explained by common risk factors. This indicates socioeconomic inequalities in the prescribing of preventive treatment after stroke.
authors.affiliation: From the Department of Statistics (M.S., M.E.), Department of Pharmacology and Clinical Neuroscience (M.S.), and Department of Public Health and Clinical Medicine (K.A., E.-L.G.), Umeå University, Umeå, Sweden; and Department of Clinical Sciences, Section of Neurology, Lund University, Lund, Sweden (B.N.). maria.sjolander@umu.se.
authors.forename: Maria
authors.initials: M
authors.lastname: Sjölander
authors.affiliation: From the Department of Statistics (M.S., M.E.), Department of Pharmacology and Clinical Neuroscience (M.S.), and Department of Public Health and Clinical Medicine (K.A., E.-L.G.), Umeå University, Umeå, Sweden; and Department of Clinical Sciences, Section of Neurology, Lund University, Lund, Sweden (B.N.).
authors.forename: Marie
authors.initials: M
authors.lastname: Eriksson
authors.affiliation: From the Department of Statistics (M.S., M.E.), Department of Pharmacology and Clinical Neuroscience (M.S.), and Department of Public Health and Clinical Medicine (K.A., E.-L.G.), Umeå University, Umeå, Sweden; and Department of Clinical Sciences, Section of Neurology, Lund University, Lund, Sweden (B.N.).
authors.forename: Kjell
authors.initials: K
authors.lastname: Asplund
authors.affiliation: From the Department of Statistics (M.S., M.E.), Department of Pharmacology and Clinical Neuroscience (M.S.), and Department of Public Health and Clinical Medicine (K.A., E.-L.G.), Umeå University, Umeå, Sweden; and Department of Clinical Sciences, Section of Neurology, Lund University, Lund, Sweden (B.N.).
authors.forename: Bo
authors.initials: B
authors.lastname: Norrving
authors.affiliation: From the Department of Statistics (M.S., M.E.), Department of Pharmacology and Clinical Neuroscience (M.S.), and Department of Public Health and Clinical Medicine (K.A., E.-L.G.), Umeå University, Umeå, Sweden; and Department of Clinical Sciences, Section of Neurology, Lund University, Lund, Sweden (B.N.).
authors.forename: Eva-Lotta
authors.initials: EL
authors.lastname: Glader
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage* / Q000191:economics*; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology; D011307:Drug Prescriptions / Q000191:economics*; D005260:Female; D054625:Healthcare Disparities / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012959:Socioeconomic Factors; D020521:Stroke / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000925:Anticoagulants
keywords: anticoagulants; atrial fibrillation; drug prescriptions; secondary prevention; socioeconomic factors