Physician-patient sex dyads and management of dyslipidaemia and hypertension in primary care: findings from two population-based studies.

Abstract

Aims: The objective of this study was to examine the associations between physician-patient sex dyads and the prevalence, treatment, and control of dyslipidaemia and hypertension in primary care.

Methods and results: We analysed two Swiss population-based studies using mixed-effects logistic models to compare dyslipidaemia and hypertension management across four physician-patient sex dyads (male physician-male patient, male physician-female patient, female physician-male patient, and female physician-female patient). Age-stratified analyses (≥50, ≥60 years) examined whether dyad-outcome associations differed by patient age. Among 8635 participants (54.9% females, with a mean age of 63 years in the CoLaus study and 48 years in the Bus Santé study), female participants had a lower prevalence of dyslipidaemia and hypertension than male participants across both study samples, irrespective of physician sex. For dyslipidaemia, in CoLaus, female participants had higher odds of lipid-lowering therapy, yet lower odds of low-density lipoprotein cholesterol control, regardless of physician sex; in Bus Santé, female participants managed by male physicians had lower odds of lipid control (adjusted odds ratios (OR) 0.52, 95% confidence intervals (CI) 0.28-0.95) compared to male physician-male patient dyads. For hypertension, in CoLaus, female physician-female patient dyads had lower odds of antihypertensive treatment (adjusted OR 0.62, 95% CI 0.42-0.92) than male physician-male patient dyads; in Bus Santé, treatment and control did not differ significantly by dyad. Most differences were more pronounced in patients aged 60 years or older.

Conclusion: In primary care, patterns of risk-factor management were associated with both patient and physician sex, with dyad-related differences that may reflect patient-sex patterns but differ in magnitude across regions and age groups.