Background Public health decision makers and healthcare payers have become increasingly interested in collecting epidemiological and economic information to improve the allocation of limited health care resources.
Objectives The purpose of this preliminary study was to describe a pharmacoepidemiological profile of patients treated for osteoarthritis (OA) by 21 general practitioners in the Local Health Unit (LHU) of Ravenna.
Methods Retrospective chronological reading of all prescriptions written for OA. All patients receiving a prescription for a NSAID or rofecoxib were included. The computerised data file, housed in the LHU of Ravenna since January 1996, contains all demographic characteristics of each patient (including diagnosis by ICD9 code) as well as the ATC code, number of packs, number of tablets per package, and cost for each drug dispensed. Rofecoxib in comparison to conventional NSAIDs and the frequency of use of GI protective agents (proton pump inhibitors, sucralfate, H2-antagonists, misoprostol, and antiacids) were considered in a period of follow-up lasted from 3 months (rofecoxib) to 18 months (NSAIDs).
Results A total of 2,935 patients received a treatment on a basis of health assisted population of 26,125 subjects: 2,878 had a NSAID and 57 rofecoxib. Among patients treated with NSAIDs 62% were female and 38% male with a mean age of 63 ± 16 and 59 ± 16 years respectively. The mean age of the patients in therapy with rofecoxib was 69 ± 13 years for female (p = 0.004 vs. NSAIDs) and 62 ± 15 years for male. Sixty-eight percent of patients treated with rofecoxib were female. The distribution by age showed that 68% of all treated patients was over 55 years old. The mean prevalence of treatment for OA was 11%. Patients belonging to the CP group who received also a GPA were treated with a significantly higher number of different NSAIDs versus those treated without a GPA (2.30 ± 1.09 vs. 2.04 ± 1.01, p < 0.001 in patients previously treated and 1.92 ± 0.87 vs. 1.78 ± 0.69, p = 0.018 in patients without previous treatment).
Conclusion These results confirm previous findings that a large part of elderly population (> = 55 years) suffers from OA and is treated with NSAIDs. The remarkable usage of GI protective agents in these patients leads to a consequent increasing of medical costs. Our preliminary data show that rofecoxib significantly improved resources utilisation reducing the frequency of use of GI protective agents (by 56% to 77%). This study provided a high number of drug utilisation data and suggested that a complete prescriptive reading in general practice might be the basis for a larger future work on pharmacoepidemiology and managed care in OA.
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