Influence of socioeconomic deprivation on the primary care burden and treatment of patients with a diagnosis of heart failure in general practice in Scotland: population based study

N. F. Murphy, F. A. McAlister, Colin Richard Simpson, Sandra Stewart, K. I. MacIntyre, M. Kirkpatrick, J. Chalmers, A. Redpath

    Research output: Contribution to journalArticle

    57 Citations (Scopus)

    Abstract

    Objectives To examine whether there are socioeconomic gradients in die incidence, prevalence, treatment, and follow up of patients with heart failure in primary care.

    Design Population based study.

    Setting 53 general practices (307741 patients) participating in the Scottish continuous morbidity recording project between 1 April 1999 and 31 March 2000.

    Participants 2186 adults with heart failure.

    Main outcome measures Comorbid diagnoses, frequency of visits to general practitioner, and prescribed drugs.

    Results 2186 patients with heart failure were seen (prevalence 7.1 per 1000 population, incidence 2.0 per 1000 population). The age and sex standardised incidence of heart failure increased with greater socioeconomic deprivation, from 1.8 per 1000 population in the most affluent stratum to 2.6 per 1000 population in the most deprived stratum (odds ratio 1.44, P=0.0003). On average, patients were seen 2.4 times yearly, but follow up rates were less frequent with increasing socioeconomic deprivation (from 2.6 yearly in the most affluent subgroup to 2.0 yearly in the most deprived subgroup, P=0.00009). Overall, 812 (80.6%) patients were prescribed diuretics, 396 (39.3%) angiotensin converting enzyme inhibitors, 216 (21.4%) beta blockers, 208 (20.7%) digoxin, and 86 (8.5%) spironolactone. The wide discrepancies in prescribing between different general practices disappeared after adjustment for patient age and sex. Prescribing patterns did not vary by deprivation categories on univariate or multivariate analyses.

    Conclusions Compared with affluent patients, socioeconomically deprived patients were 44% more likely to develop heart failure but 23% less likely to see their general practitioner on an ongoing basis. Prescribed treatment did not differ across socioeconomic gradients.

    Original languageEnglish
    Pages (from-to)1110-1112
    Number of pages2
    JournalBMJ
    Volume328
    DOIs
    Publication statusPublished - 2004

    Keywords

    • FUNCTIONAL STATUS
    • RISK-FACTORS
    • DISEASE
    • HEALTH
    • TRENDS
    • PREDICTORS
    • MANAGEMENT

    Cite this

    Influence of socioeconomic deprivation on the primary care burden and treatment of patients with a diagnosis of heart failure in general practice in Scotland: population based study. / Murphy, N. F.; McAlister, F. A.; Simpson, Colin Richard; Stewart, Sandra; MacIntyre, K. I.; Kirkpatrick, M.; Chalmers, J.; Redpath, A.

    In: BMJ, Vol. 328, 2004, p. 1110-1112.

    Research output: Contribution to journalArticle

    Murphy, N. F. ; McAlister, F. A. ; Simpson, Colin Richard ; Stewart, Sandra ; MacIntyre, K. I. ; Kirkpatrick, M. ; Chalmers, J. ; Redpath, A. / Influence of socioeconomic deprivation on the primary care burden and treatment of patients with a diagnosis of heart failure in general practice in Scotland: population based study. In: BMJ. 2004 ; Vol. 328. pp. 1110-1112.
    @article{5f4f77bb6b89483598ed7c3d7630197a,
    title = "Influence of socioeconomic deprivation on the primary care burden and treatment of patients with a diagnosis of heart failure in general practice in Scotland: population based study",
    abstract = "Objectives To examine whether there are socioeconomic gradients in die incidence, prevalence, treatment, and follow up of patients with heart failure in primary care.Design Population based study.Setting 53 general practices (307741 patients) participating in the Scottish continuous morbidity recording project between 1 April 1999 and 31 March 2000.Participants 2186 adults with heart failure.Main outcome measures Comorbid diagnoses, frequency of visits to general practitioner, and prescribed drugs.Results 2186 patients with heart failure were seen (prevalence 7.1 per 1000 population, incidence 2.0 per 1000 population). The age and sex standardised incidence of heart failure increased with greater socioeconomic deprivation, from 1.8 per 1000 population in the most affluent stratum to 2.6 per 1000 population in the most deprived stratum (odds ratio 1.44, P=0.0003). On average, patients were seen 2.4 times yearly, but follow up rates were less frequent with increasing socioeconomic deprivation (from 2.6 yearly in the most affluent subgroup to 2.0 yearly in the most deprived subgroup, P=0.00009). Overall, 812 (80.6{\%}) patients were prescribed diuretics, 396 (39.3{\%}) angiotensin converting enzyme inhibitors, 216 (21.4{\%}) beta blockers, 208 (20.7{\%}) digoxin, and 86 (8.5{\%}) spironolactone. The wide discrepancies in prescribing between different general practices disappeared after adjustment for patient age and sex. Prescribing patterns did not vary by deprivation categories on univariate or multivariate analyses.Conclusions Compared with affluent patients, socioeconomically deprived patients were 44{\%} more likely to develop heart failure but 23{\%} less likely to see their general practitioner on an ongoing basis. Prescribed treatment did not differ across socioeconomic gradients.",
    keywords = "FUNCTIONAL STATUS, RISK-FACTORS, DISEASE, HEALTH, TRENDS, PREDICTORS, MANAGEMENT",
    author = "Murphy, {N. F.} and McAlister, {F. A.} and Simpson, {Colin Richard} and Sandra Stewart and MacIntyre, {K. I.} and M. Kirkpatrick and J. Chalmers and A. Redpath",
    year = "2004",
    doi = "10.1136/bmj.38043.414074.EE",
    language = "English",
    volume = "328",
    pages = "1110--1112",
    journal = "BMJ",
    issn = "0959-8146",
    publisher = "BMJ Publishing Group",

    }

    TY - JOUR

    T1 - Influence of socioeconomic deprivation on the primary care burden and treatment of patients with a diagnosis of heart failure in general practice in Scotland: population based study

    AU - Murphy, N. F.

    AU - McAlister, F. A.

    AU - Simpson, Colin Richard

    AU - Stewart, Sandra

    AU - MacIntyre, K. I.

    AU - Kirkpatrick, M.

    AU - Chalmers, J.

    AU - Redpath, A.

    PY - 2004

    Y1 - 2004

    N2 - Objectives To examine whether there are socioeconomic gradients in die incidence, prevalence, treatment, and follow up of patients with heart failure in primary care.Design Population based study.Setting 53 general practices (307741 patients) participating in the Scottish continuous morbidity recording project between 1 April 1999 and 31 March 2000.Participants 2186 adults with heart failure.Main outcome measures Comorbid diagnoses, frequency of visits to general practitioner, and prescribed drugs.Results 2186 patients with heart failure were seen (prevalence 7.1 per 1000 population, incidence 2.0 per 1000 population). The age and sex standardised incidence of heart failure increased with greater socioeconomic deprivation, from 1.8 per 1000 population in the most affluent stratum to 2.6 per 1000 population in the most deprived stratum (odds ratio 1.44, P=0.0003). On average, patients were seen 2.4 times yearly, but follow up rates were less frequent with increasing socioeconomic deprivation (from 2.6 yearly in the most affluent subgroup to 2.0 yearly in the most deprived subgroup, P=0.00009). Overall, 812 (80.6%) patients were prescribed diuretics, 396 (39.3%) angiotensin converting enzyme inhibitors, 216 (21.4%) beta blockers, 208 (20.7%) digoxin, and 86 (8.5%) spironolactone. The wide discrepancies in prescribing between different general practices disappeared after adjustment for patient age and sex. Prescribing patterns did not vary by deprivation categories on univariate or multivariate analyses.Conclusions Compared with affluent patients, socioeconomically deprived patients were 44% more likely to develop heart failure but 23% less likely to see their general practitioner on an ongoing basis. Prescribed treatment did not differ across socioeconomic gradients.

    AB - Objectives To examine whether there are socioeconomic gradients in die incidence, prevalence, treatment, and follow up of patients with heart failure in primary care.Design Population based study.Setting 53 general practices (307741 patients) participating in the Scottish continuous morbidity recording project between 1 April 1999 and 31 March 2000.Participants 2186 adults with heart failure.Main outcome measures Comorbid diagnoses, frequency of visits to general practitioner, and prescribed drugs.Results 2186 patients with heart failure were seen (prevalence 7.1 per 1000 population, incidence 2.0 per 1000 population). The age and sex standardised incidence of heart failure increased with greater socioeconomic deprivation, from 1.8 per 1000 population in the most affluent stratum to 2.6 per 1000 population in the most deprived stratum (odds ratio 1.44, P=0.0003). On average, patients were seen 2.4 times yearly, but follow up rates were less frequent with increasing socioeconomic deprivation (from 2.6 yearly in the most affluent subgroup to 2.0 yearly in the most deprived subgroup, P=0.00009). Overall, 812 (80.6%) patients were prescribed diuretics, 396 (39.3%) angiotensin converting enzyme inhibitors, 216 (21.4%) beta blockers, 208 (20.7%) digoxin, and 86 (8.5%) spironolactone. The wide discrepancies in prescribing between different general practices disappeared after adjustment for patient age and sex. Prescribing patterns did not vary by deprivation categories on univariate or multivariate analyses.Conclusions Compared with affluent patients, socioeconomically deprived patients were 44% more likely to develop heart failure but 23% less likely to see their general practitioner on an ongoing basis. Prescribed treatment did not differ across socioeconomic gradients.

    KW - FUNCTIONAL STATUS

    KW - RISK-FACTORS

    KW - DISEASE

    KW - HEALTH

    KW - TRENDS

    KW - PREDICTORS

    KW - MANAGEMENT

    U2 - 10.1136/bmj.38043.414074.EE

    DO - 10.1136/bmj.38043.414074.EE

    M3 - Article

    VL - 328

    SP - 1110

    EP - 1112

    JO - BMJ

    JF - BMJ

    SN - 0959-8146

    ER -