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2015 HSR&D/QUERI National Conference Abstract

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3028 — Gender differences in satisfaction and confidence in lipid control among high risk Veterans

Goldstein KM, Durham VAMC - COIN; Duke University Division of General Internal Medicine; Stechuchak KS, Durham COIN; Zullig LL, Durham COIN; UNC-CH Dept of Health Policy and Management; Oddone E, Durham COIN; Duke University - Division of General Internal Medicine; Olsen MK, Durham COIN; Duke University - Department of Biostatistics and Bioinformatics; McCant FM, Durham COIN; Batch BB, Durham COIN; Duke University Division of Endocrinology; Bosworth HB, Durham COIN; Duke University - Division of Genderal Internal Medicine; Duke University Department of Psychiatry;

Objectives:
Women have poorer lipid control rates than men. It is unknown whether patient satisfaction with lipid control and confidence in the ability to improve lipids varies by gender. Among patients at high risk for cardiovascular disease, our objectives were to evaluate: 1) if satisfaction with lipid control and confidence in ability to improve it vary by gender; and 2) whether socio-demographic characteristics (e.g., health literacy and social support) modify the association.

Methods:
We examine baseline survey responses from 428 veterans (15% women) who participated in a clinical trial designed to improve cardiovascular risk. Eligible patients attended the Durham VA Medical Center-affiliated primary care clinics and had poorly controlled hypertension (defined as blood pressure > 150/100mmHg) and/or hyperlipidemia (defined as low-density lipoprotein > 130mg/dL). Questions about patient satisfaction with, and confidence in being able to change, lipid levels were examined. We describe demographic characteristics including social support, education, and financial status. We also use multi-variable regression to examine the relationship between characteristics and levels of satisfaction with and confidence in lipid levels.

Results:
Compared with men, women had higher LDL values at 141.2mg/dL vs. 124.8mg/dL respectively (p < 0.05), were younger, unmarried, had higher health literacy, and were less likely to have someone to help track their medications. In a model adjusted for socio-demographic variables, women were less satisfied with their cholesterol control than men at 4.3 versus 5.6 on a 1-10 Likert scale (least square means; p < 0.05), while there was no significant difference in confidence in ability to control lipids by gender. Those participants with support for tracking medications reported higher confidence levels than those without 7.8 versus 7.2 (p < 0.05).

Implications:
Women veterans at high risk for CVD were less satisfied with their lipid control than male veterans, though confidence in ability to improve lipid levels were similar. Veterans without someone to help with medication tracking were less confident with controlling their lipid levels and women were less likely to have this type of social support.

Impacts:
Lack of social support for medication tracking may be a potential contributing factor to lingering gender disparities in the treatment of hyperlipidemia among the veteran population