Evidence for inequalities in the management of coronary heart disease in Scotland

OBJECTIVES: To investigate whether sex, age, and deprivation inequalities existed in the prescription of secondary preventive treatment for coronary heart disease (CHD) in Scottish general practice and whether these differences altered over time. DESIGN: 6 year cross sectional study based on general practice morbidity and prescribing data. SETTING: 55 primary care practices in Scotland. SUBJECTS: 14,435 patients with diagnosed CHD. MAIN OUTCOME MEASURE: Prescription of various groups of secondary preventive treatment in six study years. RESULTS: The use of all secondary prevention treatments increased over time (63.6% of patients with CHD in 1997 to 87.6% in 2002). After adjustments for age, sex, deprivation, co-morbidities, and practice where appropriate, women received fewer secondary prevention treatments than men, a difference that increased…