Observational studyJournal of general internal medicine2021

Regularity and Continuity of GP Contacts and Use of Statins Amongst People at Risk of Cardiovascular Events.

David Youens, Jenny Doust, Suzanne Robinson, Rachael Moorin

Open access · bronzeAbstract readObservational Study
In one paragraph

Observational study in Journal of general internal medicine, 2021. The graph read 1 number from its abstract, feeding 1 cell of the map, but none could be read as for or against, so it casts no vote. Cited by 14 papers.

1number the graph read from it
0cells of the map it votes in
14citing papers in PubMed
7.5field-weighted citation impact, top 3% of its field
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.

Read, but not usablea number the graph found but could not read as for or against

Quality of life & behaviourcomparator not stated · ascvdfeeds one cell of the map
HR 0.890.84 to 0.94
Amongst 30,408 existing users, the most regular quintile had 0.82 the hazard of non-adherence (95%CI 0.78-0.87); the high continuity group had a hazard ratio of 0.89 (95%CI 0.84-0.94).

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

Statins×quality of life & behaviour

No readable resultOpen on the map →What to test next →

3 readable studies in this cell: 0 favour the treatment, 3 find no difference, 0 favour the comparator.

Belief with this paper
0.25no deciding trial · 0 families support, 0 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
1 · no effect

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

4 · 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.

5 · Its place in the literature

Who cites it

14 citing papers in PubMed, 28 citations in OpenAlex.

  1. Trial
  2. Article
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  4. Article
  5. Article
  6. Article
  7. Article
  8. DAta Linkage to Enhance Cancer Care (DaLECC): Protocol of a Large Australian Data Linkage Study.International journal of environmental research and public health · 2023
    Article
  9. Article
  10. Observational
  11. Continuity of GP care: using personal lists in general practice.The British journal of general practice : the journal of the Royal College of General Practitioners · 2022
    Article
  12. Observational
  13. Observational
  14. Article
6 · The record

Corrections and comments

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

7 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

David YouensHealth Systems and Data Analytics, School of Public Health, Curtin University, Perth, Australia. David.youens@curtin.edu.au.ORCID http://orcid.org/0000-0002-4296-4161
Jenny DoustSchool of Public Health, The University of Queensland, Brisbane, Australia.
Suzanne RobinsonHealth Systems and Data Analytics, School of Public Health, Curtin University, Perth, Australia.
Rachael MoorinHealth Systems and Data Analytics, School of Public Health, Curtin University, Perth, Australia.
Curtin University · AUBond University · AUThe University of Western Australia · AU

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

backgroundRegularity and continuity of general practitioner (GP) contacts are associated with reduced hospitalisation. Opportunities for improved medication management are cited as a potential cause.

objectiveDetermine associations between continuity and regularity of primary care and statin use amongst individuals at risk of cardiovascular disease (CVD) outcomes.

designObservational cohort study using self-report and administrative data from 267,153 participants of the Sax Institute's 45 and Up Study conducted in New South Wales, Australia. from 2006 to 2009. Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) data, from Services Australia, were linked to survey, hospital and death data by the NSW Centre for Health Record Linkage.

participantsThe 45 and Up Study participants at risk of CVD outcomes based on self-report and administrative data, divided into existing users and potential users based on dispensing records through the exposure period. MAIN MEASURES: The Continuity of Care index (COC), measuring whether patients see the same GP, and an index assessing whether GP visits are on a regular basis, measured from July 2011 to June 2012. Amongst potential users, statin initiation from July 2012 to June 2013 was assessed using logistic regression; amongst existing users, adherence was assessed from July 2012 to June 2015 using Cox regression (non-adherence being 30 days without statins). KEY

resultsAmongst 29,420 potential users, the most regular quintile had 1.22 times the odds of initiating statin (95%CI 1.11-1.34), while the high continuity group had an odds ratio of 1.12 (95%CI 1.02-1.24). Amongst 30,408 existing users, the most regular quintile had 0.82 the hazard of non-adherence (95%CI 0.78-0.87); the high continuity group had a hazard ratio of 0.89 (95%CI 0.84-0.94).

conclusionsRegularity and continuity of care impact on medication management. It is possible that this mediates impacts on hospitalisation. Where there is a risk of unobserved confounding, potential causal pathways should be investigated.

Indexed as

Cardiovascular DiseasesGeneral PractitionersHydroxymethylglutaryl-CoA Reductase InhibitorsAgedAustraliaHumansNational Health ProgramsNew South WalesHydroxymethylglutaryl-CoA Reductase Inhibitorsadherencecontinuity of caregeneral practicestatins

Identifiers

PMID33655384
PMCPMC8175539
OpenAlexW3135536409

What Socratic holds

Texttitle and abstract
Read underepoch 390

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 Socratic graph.