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Member Research and Reports

Member Research and Reports

UAB: Age and Sex Disparities in Discharge Statin Prescribing in the Stroke Belt: Evidence from the Reasons for Geographic and Racial Differences in Stroke Study

Less than half of stroke patients discharged from the hospital received a prescription for cholesterol-lowering medication called statins, and the likelihood of a prescription varied by patients’ geographic location, sex, age and race, according to new research from the UAB Reasons for Geographic and Racial Differences in Stroke Study.

“All ischemic, or non-bleeding, stroke survivors should be evaluated to determine whether they could benefit from a statin, regardless of the patient’s age, race, sex or geographic residence,” said study lead author Dr. Karen Albright, recent doctoral graduate of the University of Alabama at Birmingham School of Public Health department of epidemiology. “In patients hospitalized for ischemic stroke, opportunities exist to improve statin prescribing upon discharge.”

[Photo: Dr. Karen Albright]

The study, published in the Journal of the American Heart Association, compared discharge statin prescribing between different groups of patients with ischemic stroke both in and outside of the southeastern United States, known as the stroke belt. Researchers found that 49 percent of stroke patients who were not taking a statin prior to hospital admission received a prescription for statins at hospital discharge, though the percentage of patients’ receiving prescriptions increased over the course of the 10-year study.

“Our findings should raise questions about why so few patients get this evidence-based medication at the time of discharge and highlight variations in care by geography that may be contributing to recurrent stroke disparities,” said Dr. Justin Blackburn, assistant professor in the UAB department of health care organization and policy.

[Photo: Dr. Justin Blackburn]

The study looked at demographic and health information, including stroke risk factors, for 323 stroke patients participating in a national study of more than 30,000 U.S. adults age 45 and older from 2003 to 2013. The study used computer-assisted telephone interviews, questionnaires, an in-home examination, and medical records from the stroke hospitalization and discharge.

The study relied upon use of statins from chart abstraction of available medical records, which could have led to incorrect estimates of the number of statin users. Another limitation is that it included only patients who reported that they were not taking a statin when admitted to the hospital, which could have affected the study’s results.

Co-authors are Drs. Virginia J. Howard, professor in the SOPH department of epidemiology; George Howard, professor in the SOPH department of biostatistics; Paul Muntner, vice chair of the SOPH department of epidemiology; Vera Bittner, professor in the UAB division of cardiovascular disease; Monika M. Safford, professor in the UAB division of preventive medicine; Amelia K. Boehme, assistant professor at Columbia University; J. David Rhodes, REGARDS program director; T. Mark Beasley, professor in the SOPH department of biostatistics; Suzanne E. Judd, associate professor in the SOPH department of biostatistics; Leslie A. McClure, adjunct professor in the UAB department of biostatics; and nita Limdi, professor in the SOPH department of epidemiology.

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