Pcv86 Insurance Status and the Use of Angiotensin Ii Receptor Blockers (Arbs) and Angiotensin-Converting Enzyme (Ace) Inhibitors Among Post-Myocardial Infarction (Mi) Patients

Abstract

mendations reduced 57% the probability of uncontrolled blood pressure. Having uncontrolled blood pressure at the baseline stage increased the probability of lack of control in 166%, and per each unit of increase in body mass index the lack of control increased 7%. CONCLUSIONS: CME intervention improved the medical decision-making process to manage hypertension, thus increasing the probability of hypertensive patients to have blood pressure under control. OBJECTIVES:The objective of the study was to examine rates of depression treatment and variations in depression treatment by demographic, socioeconomic, access to care, health status, and life-style characteristics among women with hypertension. METHODS: The study design was cross-sectional, using data on from 2006 and 2007 Medical Expenditure Panel Survey (MEPS), large-scale surveys of families and individuals to provide nationally representative estimates of health care use and expenditures. The study included 1304 women aged 22 and older with hypertension and depression, identified from MEPS medical condition files. Antidepressants were identified from prescription drug reports and psychotherapy was identified from outpatient visits files. Depression treatment patterns by demographic, socioeconomic, healthcare access and health status were analyzed using chi-square tests, logistic regression and multinomial logistic regressions. All analysis accounted for the complex design of the MEPS using SAS 9.2. RESULTS: In our study sample, 23.9% had no depression treatment, 56.8% had antidepressant use only, and 19.3% had psychotherapy with or without antidepressants. Among women with hypertension and depression, African Americans (AOR ϭ 0.47), Latina (AOR ϭ 0.46), and uninsured (AOR ϭ 0.39) were significantly less likely to report any treatment for depression compared to Whites and those with private insurance. Compared to no treatment, psychotherapy with or without antidepressants was less likely among those with less than high school education and more likely among women reporting fair/poor mental health. CONCLUSIONS: Nearly onequarter of women with hypertension did not have treatment for depression. Disparities in depression treatment by race/ethnicity, health insurance, and education status were noted. Further studies need to explore reasons for not receiving depression treatment and whether such lack of treatment for depression is associated with poor health outcomes in these women.