88 Chapter 4 Outcome definition The medications included in our analysis were antiplatelets (aspirin and other antiplatelets), antihypertensives (beta-blockers, ACE inhibitors, ARBs, calcium channel blockers, and diuretics) and lipid-lowering drugs (statins and other lipid-lowering drugs). The individual drugs included in each category are listed in Supplementary table 1. The number of medications was calculated as the count of drugs from the list above that each participant reported to use. We calculated the proportion of participants taking at least one drug, at least two drugs. We considered that participants faced healthcare barriers when they reported any of the following situations in the 12 months prior to the interview: they were not able to make an appointment fast enough, to afford care in general, to afford to visit a doctor, or to afford prescription drugs in the previous year. Data analysis For categorical variables, we report the number of participants and the percentage from the total in each category. Numerical variables are presented as mean and standard error (SE). Univariable differences between participants with only public and additional insurance were tested with chi-square test for categorical variables, and t-test for numerical variables. In a multivariable analysis, we explored potential differences in the number of medications, and the use of at least one drug, at least two drugs and reported healthcare barriers by insurance coverage controlled by age, sex, educational level, and reported healthcare barriers (for the medication outcomes). We built a Poisson regression model for the outcome number of medications, while logistic regression models were used for the outcomes at least one drug, at least two drugs and at least two classes of drugs. All analysis were performed using the “survey” package (28) in R Studio version 4.03 (29). RESULTS Characteristics of the study population The main characteristics of the study population are shown in Table 1 by insurance status. Mean age was 60.1 years (SE 0.4 years), and 49.7% of the participants with CHD were female. Most participants (54.3%) had primary school educational level, and this proportion was higher in the uninsured group (p= 0.016). More than half of the participants (57.7%) were only covered only by the public system. Among the insured participants, most had social work coverage (85.3%) and 14.7% had a private health insurance. The most common CHD diagnosis was angina (78.1%). The proportion of participants that had undergone cardiovascular revascularization was significantly higher among participants with additional coverage (29.9% vs. 18.1%, p=0.001). Cardiovascular risk factors were highly prevalent: 95.1% of participants were hypertensive and 82.0% had dyslipidemia.
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