Q J Med 2001; 94: 301-308
© 2001 Association of Physicians
Are patients suffering from stable angina receiving optimal medical treatment?
1 From the Department of Family Medicine, Groupe Interdisciplinaire de Recherche en Santé (GRIS), 2 Centre de Recherche Centre Hospitalier de l'Université de Montréal, Université de Montréal, 3 Department of Health Administration and GRIS, Université de Montréal, 4 Practice Enhancement Division, Collège des médecins du Québec, and 5 Department of Epidemiology and Biostatistics, McGill University, Montréal, Canada
Received 1 March 2001 and in revised form 5 April 2001
There is good evidence for the use of antiplatelet, beta-blocker and lipid-lowering drugs in the treatment of ischaemic heart disease, but few data on how these medications are used in treating stable angina pectoris. We examined prescription profiles for a sample of patients aged 
65 years with stable angina, to compare the profiles to local guidelines and to explore the determinants of these profiles, in a cross-sectional study. We identified 11 141 individuals from the Quebec provincial out-patient pharmaceutical database for the period 1 June 1996 to 31 May 1997, and examined the percentage of these patients with and without associated co-morbidities receiving antiplatelet, beta-blocker and lipid-lowering medications. We used hierarchical modelling to examine the role of patient and physician characteristics in explaining the variation in the use of these medications. Calcium-channel blockers were the class of anti-ischaemic drugs most prescribed (63%). Beta-blockers were prescribed in 52.1% of patients. Antiplatelet and lipid-lowering drugs were prescribed to 56.8% and 32.6%, respectively. Increasing age and female gender made patients less likely to be prescribed these treatments. General practitioners were less likely than cardiologists to prescribe beta-blockers and lipid-lowering drugs (OR 0.79, CI 95% 0.68–0.91 and OR 0.77, CI 95% 0.66–0.91, respectively). There is a general under-use of antiplatelet, beta-blocker and lipid-lowering medications in the treatment of stable angina pectoris patients, possibly leading to adverse patient outcomes.
Address correspondence to Dr M.-D. Beaulieu, Research Centre of the Centre Hospitalier de l'Université de Montréal, Pavillon Louis-Charles Simard, Pavillon Notre-Dame, 1560 Sherbrooke Est, 8e étage, Montreal (Quebec) H2L 4M1, Canada. e-mail: maried.beaulieu{at}sympatico.ca
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  P. M. Colletti Coronary CT Angiography Without {beta}-Blockers Am. J. Roentgenol., December 1, 2007; 189(6): 1324 - 1325. [Full Text] [PDF]
|
|
|
|
 |
|
 V. B. Shahinian, Y.-F. Kuo, J. L. Freeman, and J. S. Goodwin Determinants of androgen deprivation therapy use for prostate cancer: role of the urologist. J Natl Cancer Inst, June 21, 2006; 98(12): 839 - 845. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. K. Choudhry, R. H. Fletcher, and S. B. Soumerai Systematic Review: The Relationship between Clinical Experience and Quality of Health Care Ann Intern Med, February 15, 2005; 142(4): 260 - 273. [Abstract] [Full Text] [PDF]
|
|