Insuring the Uninsured Is Not Enough

Dalen, James E.

doi:10.1001/archinte.1991.00400050014004

Cited by 3 publications

(1 citation statement)

References 17 publications

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“…For our primary analysis, we created a propensity score-matched cohort to determine the association between statin use and gonado-sexual dysfunction. Propensity scores were created using a multivariable logistic regression model [26], and a caliper of 0.07 to perform nearest number matching [27]. We included 79 variables in the derivation of the propensity scores: age, 17 comorbidities as defined by Deyo et al [25], total CCI score, obesity, alcohol dependence/abuse, illicit drug use, cigarette smoking, health-care utilization (number of outpatient visits and inpatient admissions during baseline period, and number of encounters for immunization or prevention of infectious diseases), 16 cardiovascular disease groups as defined by AHRQ-CCS categories, 1 cerebrovascular disease group that comprises 3 AHRQ-CCS categories, 17 other group of comorbidities as defined by AHRQ-CCS, and use of 19 medication groups (Appendix).…”

Section: Patient Outcomesmentioning

confidence: 99%

The Association of Statin Use and Gonado-Sexual Function in Women: A Retrospective Cohort Analysis

Ali

Reveles

Davis

et al. 2015

The Journal of Sexual Medicine

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Introduction It has been hypothesized that statins reduce sex hormone biosynthesis through hepatic inhibition of cholesterol synthesis, which is a precursor of androstenedione and estradiol. Such a reduction has been associated with menstrual irregularities, menopausal disorders, infertility, and low libido, but studies are conflicting. Few studies have evaluated the clinical effects of statins on gonadal-sexual function in women. Aim To compare the risk of gonado-sexual dysfunction in statin users vs. nonusers. Methods This was a retrospective cohort study of all female, adult patients (30–85 years) enrolled in the Tricare Prime/Plus San Antonio catchment area. Using 79 baseline characteristics, we created a propensity score-matched cohort of statin users and nonusers. The study duration was divided into a baseline period (October 1, 2003 to September 30, 2005) to describe patient baseline characteristics and a follow-up period (October 1, 2005 to March 1, 2012) to determine patient outcomes. Statin users were defined as those prescribed a statin for ≥3 months between October 1, 2004 and September 30, 2005. Logistic regression was used to determine the association of statin use with patient outcomes. Main Outcome Measures Outcomes included menstrual disorders, menopausal disorders, infertility, and ovarian/sexual dysfunction during the follow-up period. Outcomes were identified using inpatient or outpatient International Classification of Diseases, Ninth Revision, Clinical Modification codes as defined by the Agency for Healthcare Research and Quality’s Clinical Classifications Software. Results Of 22,706 women who met study criteria, we propensity score-matched 2,890 statin users with 2,890 nonusers; mean age 58 ± 12 years. Statin use was not significantly associated with menstrual disorders (OR 0.97; 95% CI 0.81–1.16), menopausal disorders (OR 0.92; 95% CI 0.83–1.02), infertility (OR 0.79; 95% CI 0.36–1.73), or ovarian/sexual dysfunction (OR 1.18; 95% CI 0.83–1.70). Conclusions Statin use was not associated with higher risk of gonado-sexual dysfunction in women.

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Section: Patient Outcomesmentioning

confidence: 99%