Evidence map›Paper›PMID 39352020›Full record

ArticleStroke2025

Sex Differences in Prescription Patterns and Medication Adherence to Guideline-Directed Medical Therapy Among Patients With Ischemic Stroke.

Hend Mansoor, Daniel Manion, Anna Kucharska-Newton, Chris Delcher, Wei-Hsuan Lo-Ciganic, Gregory A Jicha, Daniela C Moga

Abstract read
In one paragraph

Article in Stroke, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
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  3. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Hend MansoorDepartment of Pharmacy Practice and Science (H.M., D.M., C.D., D.C.M.), University of Kentucky, Lexington.ORCID 0000-0002-3940-4155
Daniel ManionDepartment of Pharmacy Practice and Science (H.M., D.M., C.D., D.C.M.), University of Kentucky, Lexington.ORCID 0009-0002-1561-1608
Anna Kucharska-NewtonDepartment of Epidemiology and Environmental Health (A.K.-N., D.C.M.), University of Kentucky, Lexington.ORCID 0000-0001-9864-467X
Chris DelcherDepartment of Pharmacy Practice and Science (H.M., D.M., C.D., D.C.M.), University of Kentucky, Lexington.ORCID 0000-0001-7214-0326
Wei-Hsuan Lo-CiganicDivision of General Internal Medicine, School of Medicine (W.-H.L.-C.), University of Pittsburgh, PA.ORCID 0000-0001-6590-4770
Gregory A JichaDepartment of Neurology (G.A.J.), University of Kentucky, Lexington.ORCID 0000-0002-7980-2166
Daniela C MogaDepartment of Pharmacy Practice and Science (H.M., D.M., C.D., D.C.M.), University of Kentucky, Lexington.ORCID 0000-0002-3648-8197

Funding

University of Kentucky Alzheimer's Disease Research CenterP30AG072946 · NIA · UNIVERSITY OF KENTUCKY · PI Erin Abner · 2021 to 2026
$23.5M
Supplement for Kentucky BIRCWH Program: Training the Next Generation of Women's Health Scholars: Dr. ConnerK12DA035150 · NIDA · UNIVERSITY OF KENTUCKY · PI Thomas E Curry · 2012 to 2026
$9.0M
NIA NIH HHS P30 AG072946NIDA NIH HHS K12 DA035150
6 · The paper itself

Abstract

backgroundIschemic stroke is a leading cause of death and disability. Society guidelines recommend pharmacotherapies for secondary stroke prevention. However, the role of sex differences in prescription and adherence to guideline-directed medical therapies (GDMT) after ischemic stroke remains understudied. The aim of this study was to examine sex differences in prescription patterns and adherence to GDMT at 1 year after ischemic stroke in a cohort of commercially insured patients.

methodsUsing the Truven Health MarketScan database from 2016 to 2020, we identified patients admitted with ischemic stroke. GDMT was defined as any statin, antihypertensive agents, or oral anticoagulant prescription within 30 days after discharge. Medication adherence was estimated using the proportion of days covered at 1 year. The proportion of days covered <0.80 was used to define nonadherence. A multivariable model adjusting for covariates was performed to identify the factors associated with nonadherence at 1 year. This analysis was restricted to new users of GDMT.

resultsAmong 155 220 patients admitted with acute ischemic stroke during the study period, 15 919 met the inclusion criteria. The mean age was 55.7 years, and 8218 (51.7%) were women. Women were less likely to be prescribed statins (58.0% versus 71.8%) and antihypertensive agents (27.7% versus 41.8%). In this subset of patients with atrial flutter/fibrillation, women were also less likely to be prescribed oral anticoagulants (41.2% versus 45.0%). Women were more likely to be nonadherent (ie, proportion of days covered <0.80) to statins (47.3% versus 41.6%;

conclusionsIn this real-world analysis of commercially insured patients with ischemic stroke, women were less likely initiated on GDMT within 30 days after discharge. Women were more likely to be nonadherent to statins and antihypertensive agents at 1 year. Future efforts and novel interventions are needed to understand the reasons and minimize these disparities.

Indexed as

Antihypertensive AgentsBrain IschemiaIschemic StrokeMedication AdherencePractice Patterns, Physicians'AdultAgedAnticoagulantsFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedSex FactorsAnticoagulantsAntihypertensive AgentsHydroxymethylglutaryl-CoA Reductase Inhibitorsantihypertensive agentsfemalehydroxymethylglutaryl-CoA reductase inhibitorsischemic strokestroke

Identifiers

PMID39352020
PMCPMC11772120

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.