{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T05:51:39Z","timestamp":1783403499461,"version":"3.54.6"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T00:00:00Z","timestamp":1700524800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Victorian Medical Research Acceleration Fund"},{"DOI":"10.13039\/100008710","name":"Dementia Australia Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008710","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>People in remote areas may have more difficulty accessing healthcare following myocardial infarction (MI) than people in metropolitan areas. We determined whether remoteness was associated with initial and 12-month use of secondary prevention medications following MI in Victoria, Australia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>We included all people alive at least 90 days after discharge following MI between July 2012 and June 2017 in Victoria, Australia (n = 41 925). We investigated dispensing of P2Y12 inhibitors (P2Y12i), statins, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ACEIs\/ARBs), and beta-blockers within 90 days after discharge. We estimated 12-month medication use using proportion of days covered (PDC). Remoteness was determined using the Accessibility\/Remoteness Index of Australia (ARIA). Data were analysed using adjusted parametric regression models stratified by ST elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI). There were 10 819 STEMI admissions and 31 106 NSTEMI admissions. Following adjustment across NSTEMI and STEMI, there were no medication classes dispensed in the 90-day post-discharge that differed in a clinically significant way from the least remote (ARIA = 0) to the most remote (ARIA = 4.8) areas. The largest difference for NSTEMI was ACEI\/ARB, with 71% (95% confidence interval 70\u201372%) vs. 80% (76\u201383%). For STEMI, it was statins with 89% (88\u201390%) vs. 95% (91\u201397%). Predicted PDC for STEMI and NSTEMI was not clinically significant across remoteness, with the largest difference in NSTEMI being P2Y12i with 48% (47\u201350%) vs. 55% (51\u201359%), and in STEMI, it was ACEI\/ARB with 68% (67\u201369%) vs. 76% (70\u201380%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Remoteness does not appear to be a clinically significant driver for medication use following MI. Possible differences in cardiovascular outcomes in metropolitan and non-metropolitan areas are not likely to be explained by access to secondary prevention medications.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwad360","type":"journal-article","created":{"date-parts":[[2023,11,18]],"date-time":"2023-11-18T14:50:17Z","timestamp":1700319017000},"page":"580-588","source":"Crossref","is-referenced-by-count":8,"title":["Use of secondary prevention medications in metropolitan and non-metropolitan areas: an analysis of 41 925 myocardial infarctions in Australia"],"prefix":"10.1093","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5337-8061","authenticated-orcid":false,"given":"Adam C","family":"Livori","sequence":"first","affiliation":[{"name":"Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University , VIC , Australia"},{"name":"Grampians Health , Ballarat, VIC , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0625-3522","authenticated-orcid":false,"given":"Zanfina","family":"Ademi","sequence":"additional","affiliation":[{"name":"Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University , VIC , Australia"},{"name":"School of Public Health and Preventive Medicine, Monash University , Melbourne, VIC , Australia"},{"name":"Monash Data Futures Institute, Monash University , Melbourne, VIC , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenni","family":"Ilom\u00e4ki","sequence":"additional","affiliation":[{"name":"Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University , VIC , Australia"},{"name":"School of Public Health and Preventive Medicine, Monash University , Melbourne, VIC , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0396-3825","authenticated-orcid":false,"given":"Derk","family":"Pol","sequence":"additional","affiliation":[{"name":"Latrobe Regional Hospital , Traralgon, VIC , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3231-5758","authenticated-orcid":false,"given":"Jedidiah I","family":"Morton","sequence":"additional","affiliation":[{"name":"Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University , VIC , Australia"},{"name":"Department of Diabetes and Population Health, Baker Heart and Diabetes Institute , Melbourne, VIC , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6115-2767","authenticated-orcid":false,"given":"J Simon","family":"Bell","sequence":"additional","affiliation":[{"name":"Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University , VIC , Australia"},{"name":"School of Public Health and Preventive Medicine, Monash University , Melbourne, VIC , Australia"},{"name":"Monash Data Futures Institute, Monash University , Melbourne, VIC , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,11,21]]},"reference":[{"key":"2024032723420202200_zwad360-B1","doi-asserted-by":"crossref","first-page":"3227","DOI":"10.1093\/eurheartj\/ehab484","article-title":"2021 ESC guidelines on cardiovascular disease prevention in clinical practice","volume":"42","author":"Visseren","year":"2021","journal-title":"Eur Heart J"},{"key":"2024032723420202200_zwad360-B2","doi-asserted-by":"crossref","first-page":"3495","DOI":"10.1093\/eurheartj\/ehaa624","article-title":"2020 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment 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