Is the physician's adherence to prescription guidelines associated with the patient's socio-economic position? An analysis of statin prescription in South Sweden

State and self investments in health

“…Undertreatment with lipid-lowering drugs amongst older people and women has been highlighted by Tonstad et al (2004) in the Oslo Health Study and by Ma et al (2005) in the U.S. National Ambulatory Medical Care Survey. Other studies find that doctor's prescription of lipid-lowering drugs is related to the socioeconomic status (SES) of the patient (Scott et al, 1996;Ohlsson et al, 2010). Reid et al (2002) also suggest that smokers are at a disadvantage for receiving lipid lowering therapy.…”

“…These results are available from the authors upon request. 5 Given the literature on the influence of SES on doctor's decision to prescribe, we have included socioeconomic factors in the lipid lowering-drugs and advice equation (Scott et al, 1996;Ohlsson et al, 2010). Education and income were significant, but the size and the significance of lipid-lowering drugs remained unchanged.…”

Is physician adherence to prescription guidelines a general trait of health care practices or dependent on drug type?—A multilevel logistic regression analysis in South Sweden

“…This phenomenon has been suggested to be an expression of different therapeutic traditions. [1][2][3][4] While this contextual phenomenon has been shown for different isolated outcomes, such as the ordering of specific tests, 5 prescribing rates, 1,2 early adoption of newly marketed drugs 6 or adherence to prescription guide-lines for specific drugs like statins, 3,4,7 it is still not known if this phenomenon is a general HCP trait that affects all kinds of prescription behaviour or if it is dependent on specific outcomes. In the present study we investigate this question by focussing on adherence to prescription guidelines for different types of drugs.…”

“…We use multilevel logistic regression analysis (MLRA) 8 within a previously developed framework [1][2][3][4]6,7 that quantifies therapeutic traditions by means of clustering of similar prescription behaviour within the same HCP. We first investigate the clustering of adherence to prescription guidelines regarding three separate drug types: statins, agents acting on the reninangiotensin system and proton pump inhibitors.…”

Inequality in provision of medical care in Sweden: a case of social epidemiological hypochondria?

“…The last of these is the focus of the methodologically impressive new study by Ohlsson and colleagues in this issue of JECH ( see page ) 4. The authors use a remarkably comprehensive data resource, which captures 13% of Sweden's entire population in a multi-level, linked-record database that includes five decades of population surveillance 5.…”