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The Use of Antiplatelet Agents for Secondary Prevention of Ischemic Stroke in U.S. Ambulatory Care Settings
Abstract

Abstract:

Introduction. We examined stroke prevention with antiplatelet agents by U.S. nonfederal office physicians and hospital outpatient departments from 2005–2006.

Methods. The nationally representative dataset used a multistage (112 primary sampling units, physicians/ hospitals, patient medical records) random sample of 1,702 visits by patients 20 years or older with cerebrovascular disease (national estimate: 15.4 million annual visits). Dependent variable: use of antiplatelet agents for patients without contraindications. Independent variables: age, sex, race/ethnicity, payment, primary care provider, prior visits in last year, comorbidities. Logistic regression was used to investigate associations with recommended interventions.

Results. Antiplatelet agents were prescribed at 31.1% of visits. Positive predictors: seeing the patient’s primary care provider and having five or more comorbidities. Negative predictors: non-Hispanic Black race/ethnicity and having six or more prior visits in the last year.

Conclusion. Variations by visit characteristics suggest that improvement in using antiplatelet agents is possible, especially for non-Hispanic Black patients.