Eliminating Health Disparities in Atrial Fibrillation, Heart Failure, and Dyslipidemia: A Path Toward Achieving Pharmacoequity.

Date

2023-12

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Abstract

Purpose of review

Pharmacoequity refers to the goal of ensuring that all patients have access to high-quality medications, regardless of their race, ethnicity, gender, or other characteristics. The goal of this article is to review current evidence on disparities in access to cardiovascular drug therapies across sociodemographic subgroups, with a focus on heart failure, atrial fibrillation, and dyslipidemia.

Recent findings

Considerable and consistent disparities to life-prolonging heart failure, atrial fibrillation, and dyslipidemia medications exist in clinical trial representation, access to specialist care, prescription of guideline-based therapy, drug affordability, and pharmacy accessibility across racial, ethnic, gender, and other sociodemographic subgroups. Researchers, health systems, and policy makers can take steps to improve pharmacoequity by diversifying clinical trial enrollment, increasing access to inpatient and outpatient cardiology care, nudging clinicians to increase prescription of guideline-directed medical therapy, and pursuing system-level reforms to improve drug access and affordability.

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Description

Provenance

Citation

Published Version (Please cite this version)

10.1007/s11883-023-01180-5

Publication Info

Amin, Krunal, Garrett Bethel, Larry R Jackson, Utibe R Essien and Caroline E Sloan (2023). Eliminating Health Disparities in Atrial Fibrillation, Heart Failure, and Dyslipidemia: A Path Toward Achieving Pharmacoequity. Current atherosclerosis reports, 25(12). pp. 1113–1127. 10.1007/s11883-023-01180-5 Retrieved from https://hdl.handle.net/10161/30135.

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Scholars@Duke

Jackson

Larry Ronald Jackson

Associate Professor of Medicine

Dr. Jackson is a physician-scientist with clinical expertise in adult clinical cardiac electrophysiology. His research focuses on identifying determinants of racial/ethnic differences in arrhythmia care and the development and implementation of patient-centered interventions aimed at facilitating shared decision-making in populations that have been systemically disadvantaged with abnormal heart rhythm conditions. Dr. Jackson has an advanced degree (MHSc) in clinical and qualitative research methodology and is a member of the Duke Clinical Research Institute. His research skills, obtained during his time at the Duke Clinical Research Institute Research Fellowship, include formal training in large database analysis, clinical trial operations, scientific writing, clinical trial adjudication and statistical analysis. Dr. Jackson’s research funding consists of two career development awards: 1) National Institute of Health/National Heart, Lung, and Blood Institute-K01 focused on racial and ethnic differences in oral anticoagulation use in patients with atrial fibrillation and 2) AHA career development award focused on analyzing racial and ethnic differences in the use of rhythm control strategies in patients with atrial fibrillation.  Dr. Jackson’s long-term, overarching goal as a physician-scientist is to decrease racial and ethnic disparities in arrhythmia care for patients with abnormal heart rhythm conditions.

Sloan

Caroline Sloan

Assistant Professor of Medicine

Caroline is a General Internist. Her clinical interests are in primary care for vulnerable populations and patients with multiple chronic conditions. Her research interests focus on the role that money plays in medical decision-making. She currently studies financial barriers to care for patients with multiple chronic conditions, the impact of recent price transparency regulations, and the ways that doctors and patients communicate about and make decisions based on out-of-pocket costs.


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