90 Chapter 4 Medication use by insurance coverage Antiplatelet drugs were used by 28.3.3% of the participants and more than half of participants used antihypertensive medication (51.9%). Participants with additional coverage presented higher use of beta-blockers (25.3 % vs. 17.1%, p=0.021) and lower use of ACE-inhibitors (22.5% vs. 31.4%, p=0.028) compared to participants covered only by the public system. 24.4% of participants used lipid-lowering medication. Among diabetic participants, there was a 55.9% of oral hypoglycemic use and 8.9% of insulin use, the latter being higher among participants with public healthcare coverage (3.9% vs. 12.3%, p=0.040) (Figure 2, Supplementary Table 2). The mean number of medications per participant was 1.8 (SE 0.1). Most participants (95.4%) were using at least one medication and 59.3% were using at least two medications (Figure 2). There were no significant differences between coverage groups in the number of medications in the univariable (Figure 2, Supplementary Table 2) and multivariable analysis (Table 2). Barriers to healthcare use 21.7% of the participants reported to have encountered barriers to receive medical care they needed, and this proportion was higher among participants without additional coverage (26.1% vs. 13.2%, p=0.001) (Table 3). This difference persisted in the multivariable analysis adjusted by age, sex, prior coronary revascularization and educational level: OR of reporting barriers in the uninsured compared to insured was 3.32 (95% CI 1.61 – 6.87) (Table 2). Figure 2. Percentage of medication use by medication class and insurance status. The use of antiddiabetics is represented as percentage of participants using antidiabetic medications among diabetic subjects. Note: Results are expressed in percentages. * Indicates significant differences.
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