Introduction: Adherence to guidelines varies between care units and care givers. In Stockholm region the dispensation of statins vary 3-fold among primary care centers (figure). Although this may influence the patient outcome, little is known of which factors induce the variation. Aims: To describe differences in dispensation of secondary stroke preventive drugs between patients at different primary care centers (PCC´s) in Stockholm County and to identify factors on PCC- and patient level that may explain the variation. Material and Methods: A cohort study using data from the Central Regional Data Warehouse of Stockholm County on 7562 patients listed at a 187 PCC in Stockholm County. Patients with an ischemic stroke treated in hospital between 2009 and 2014 were studied. The exclusion criteria were: deceased patients, age<18, haemorrhagic stroke and/or changing PCC. The impact of PCC organisation variables and patient characteristics on the dispensation of statins, antiplatelets, antihypertensives and anticoagulants were analysed. Results: Factors associated with a lower level of dispensed statins were privately run PCC´s and the patient being female. Increased statin use was associated with a higher number of specialists in Family Medicine at the PCC and a higher proportion of patient listings at a specific physician and not only with the PCC-unit. Conclusion: Factors, both at patient- and PCC–level, may influence practice variation in secondary stroke prevention. We identified female sex and the PCC being privately run to be associated with lower dispensation of preventive drugs. Factors suggesting good continuity of care and high competence in treating physician were positively associated with the dispensation of stroke preventive drugs.
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