Women Less Likely to Receive, Take GDMT After Stroke

TOPLINE:
Women with ischemic stroke are less likely than men with the condition to be prescribed guideline-directed medical therapies (GDMTs) within 30 days post-discharge. Women are also less likely than men to adhere to statins and antihypertensives at 1 year.
METHODOLOGY:
Researchers conducted a retrospective cohort analysis using the Truven Health MarketScan database from 2016 to 2020.
Adults hospitalized for acute ischemic stroke or transient ischemic attack and newly started on GDMTs were included (n = 15,919; 48% women).
The primary outcome was the difference in the initiation of GDMTs between women and men. GDMT was defined as any statin, antihypertensive, or anticoagulant prescription made within 30 days following discharge.
Medication adherence was estimated using the proportion of days covered (PDC) at 1 year, with PDC < 0.80 defined as nonadherence.
TAKEAWAY:
Within 30 days of hospital discharge, 65% of patients were initiated on a statin and 35% were initiated on an antihypertensive. Women were less likely than men to be prescribed statins (58% vs 72%), high-potency statins (40% vs 54), oral anticoagulants (41% vs 45%), including direct oral anticoagulants (35% vs 38%), and any antihypertensive agent (28% vs 42%), even in a subgroup of patients with hypertension (46% vs 58%).
Women with atrial fibrillation or flutter were also less likely than men to receive any anticoagulant (41% vs 45%).
At 1 year, women were significantly more likely than men to be nonadherent to statins (47% vs 42%; P < .0001), antihypertensives (33% vs 32%; P = .01), or a combination of the two ( 50% vs 45%; P = .006).
Multivariable analysis showed that women had higher odds of nonadherence to GDMTs at 1 year than men (odds ratio, 1.23; 95% CI, 1.08-1.41).
IN PRACTICE:
“These findings are concerning given the relatively young age of the patients included in this analysis and warrant further investigation into potential underlying causes, which may be patient- or provider-related,” the authors wrote.
SOURCE:
The study was led by Hend Mansoor, PharmD, PhD, University of Kentucky, Lexington, Kentucky. It was published online on October 1 in Stroke.
LIMITATIONS:
The retrospective, observational nature of the study may have introduced residual or unmeasured confounding. Factors affecting adherence to treatment, including education and socioeconomic status, were not studied. The lack of information on race and ethnicity limits the generalizability across racial and ethnic groups. The dataset’s lack of information on antiplatelet therapy initiation and adherence, as well as the inability to confirm medication intake, are additional limitations.
DISCLOSURES:
Study funding was not disclosed. One author disclosed membership in the Pharmacy Quality Alliance and reported receiving grants from various sources. Details are provided in the original article.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
 
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