Gender Differences in Patient-Reported Outcomes Among Adults With Atherosclerotic Cardiovascular Disease

J Am Heart Assoc. 2018 Dec 18;7(24):e010498. doi: 10.1161/JAHA.118.010498.

Abstract

Background Atherosclerotic cardiovascular disease ( ASCVD ) accounts for approximately one third of deaths in women. Although there is an established relationship between positive patient experiences, health-related quality of life, and improved health outcomes, little is known about gender differences in patient-reported outcomes among ASCVD patients. We therefore compared gender differences in patient-centered outcomes among individuals with ASCVD . Methods and Results Data from the 2006 to 2015 Medical Expenditure Panel Survey, a nationally representative US sample, were used for this study. Adults ≥18 years with a diagnosis of ASCVD , ascertained by International Classification of Diseases, Ninth Revision ( ICD-9) codes and/or self-reported data, were included. Linear and logistic regression were used to compare self-reported patient experience, perception of health, and health-related quality of life by gender. Models adjusted for demographics, socioeconomic status, and comorbidities. There were 21 353 participants included, with >10 000 (47%-weighted) of the participants being women, representing ≈11 million female adults with ASCVD nationwide. Compared with men, women with ASCVD were more likely to experience poor patient-provider communication (odds ratio 1.25 [95% confidence interval 1.11-1.41]), lower healthcare satisfaction (1.12 [1.02-1.24]), poor perception of health status (1.15 [1.04-1.28]), and lower health-related quality of life scores. Women with ASCVD also had lower use of aspirin and statins, and greater odds of ≥2 Emergency Department visits/y. Conclusions Women with ASCVD were more likely to report poorer patient experience, lower health-related quality of life, and poorer perception of their health when compared with men. These findings have important public health implications and require more research towards understanding the gender-specific differences in healthcare quality, delivery, and ultimately health outcomes among individuals with ASCVD .

Keywords: cardiovascular disease; health outcomes; health‐related quality of life; secondary prevention; women.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Atherosclerosis / epidemiology
  • Atherosclerosis / physiopathology
  • Atherosclerosis / psychology
  • Atherosclerosis / therapy*
  • Cross-Sectional Studies
  • Female
  • Health Communication
  • Health Knowledge, Attitudes, Practice
  • Health Status Disparities*
  • Healthcare Disparities*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Male
  • Middle Aged
  • Patient Reported Outcome Measures*
  • Patient Satisfaction
  • Physician-Patient Relations
  • Platelet Aggregation Inhibitors / therapeutic use
  • Quality of Life
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • United States / epidemiology
  • Young Adult

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Platelet Aggregation Inhibitors