Pharmacotherapeutic disparities: Racial, ethnic, and sex variations in medication treatment

Purpose. Variations in the medication treatment received by racial and ethnic minorities and women and the negative health outcomes associated with these differences were examined. Methods. Studies published between January 1990 and June 2008 were identified via electronic searches of MEDLINE, PsychINFO, International Pharmaceutical Abstracts, PubMed, and CINAHL using search terms related to race, ethnicity, sex, drug treatment, and disparity or variation. Articles were excluded if they addressed only medical or surgical care or did not include a statistical analysis of differences in drug treatment based on race, ethnicity, or sex. Data regarding the frequency of reported race, ethnic, and sex differences in medication treatment, the types of treatment differences observed, and associated health outcomes were extracted. Results. A total of 311 research articles were identified that investigated whether race, ethnicity, or sex was associated with disparities in medication treatment. Seventy-seven percent (n = 240) of included articles revealed significant disparities in drug treatment across race, ethnicity, and sex (p < 0.05). The most frequent disparity, found in 73% of the articles studied, was differences in the receipt of prescription drugs; however, documented disparities occurred related to differences in the drugs prescribed, drug dosing or administration, and wait time to receipt of a drug. Documented outcomes associated with pharmacotherapeutic disparities included increased rates of hospitalization, decreased rates of therapeutic goal attainment (e.g., low-density-lipoprotein cholesterol, blood pressure goals), and decreased rates of survival. Conclusion. A literature review revealed significant disparities in the medication treatment received by racial and ethnic minorities and women.