The therapeutic approaches of community based primary care practitioners to osteoarthritis of the hip in an elderly patient

S. A. Mazzuca, K. D. Brandt, S. L. Anderson, B. S. Musick, Barry Katz

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Predispositions to prescribe a pure analgesic, a cyclooxygenase inhibiting nonsteroidal antiinflammatory drug (NSAID) or a nonacetylated salicylate for a fictitious, uncomplicated case of osteoarthritis (OA) were surveyed in a sample of 152 community based primary care practitioners who had been characterized with respect to medical education and practice characteristics. Only 2 respondents (1%) prescribed a pure analgesic; 35% prescribed subantiinflammatory doses of cyclooxygenase inhibiting NSAID. The remainder (64%) recommended nonacetylated salicylates and cyclooxygenase inhibiting NSAID in doses large enough to achieve an antiinflammatory effect. Past participants in postgraduate rheumatology electives prescribed more costly regimens than those who had not participated (p = 0.05). When the case was altered to include a history of previous peptic ulcer, 44% chose cyclooxygenase inhibiting NSAID with adjunctive prophylaxis against NSAID-induced gastropathy (e.g., misoprostol). When the complication was changed to renal insufficiency, recommendations for sulindac increased 3-fold over those for the uncomplicated case (34 vs 11%), and were most common among more recent medical school graduates and past participants in rheumatology electives (p < 0.05 for both). The potential effects of educational and practice variables on the therapeutic strategies and costs of OA care in the community merit further systematic study.

Original languageEnglish
Pages (from-to)1593-1600
Number of pages8
JournalJournal of Rheumatology
Volume18
Issue number10
StatePublished - 1991

Fingerprint

Therapeutic Community
Hip Osteoarthritis
Primary Health Care
Anti-Inflammatory Agents
Prostaglandin-Endoperoxide Synthases
Pharmaceutical Preparations
Salicylates
Rheumatology
Osteoarthritis
Analgesics
Sulindac
Misoprostol
Medical Education
Peptic Ulcer
Medical Schools
Renal Insufficiency
Costs and Cost Analysis

Keywords

  • analgesia
  • NSAID
  • osteoarthritis treatment
  • primary care physicians

ASJC Scopus subject areas

  • Immunology
  • Rheumatology

Cite this

The therapeutic approaches of community based primary care practitioners to osteoarthritis of the hip in an elderly patient. / Mazzuca, S. A.; Brandt, K. D.; Anderson, S. L.; Musick, B. S.; Katz, Barry.

In: Journal of Rheumatology, Vol. 18, No. 10, 1991, p. 1593-1600.

Research output: Contribution to journalArticle

Mazzuca, S. A. ; Brandt, K. D. ; Anderson, S. L. ; Musick, B. S. ; Katz, Barry. / The therapeutic approaches of community based primary care practitioners to osteoarthritis of the hip in an elderly patient. In: Journal of Rheumatology. 1991 ; Vol. 18, No. 10. pp. 1593-1600.
@article{f4da70d962d94cc4b29b990940f43010,
title = "The therapeutic approaches of community based primary care practitioners to osteoarthritis of the hip in an elderly patient",
abstract = "Predispositions to prescribe a pure analgesic, a cyclooxygenase inhibiting nonsteroidal antiinflammatory drug (NSAID) or a nonacetylated salicylate for a fictitious, uncomplicated case of osteoarthritis (OA) were surveyed in a sample of 152 community based primary care practitioners who had been characterized with respect to medical education and practice characteristics. Only 2 respondents (1{\%}) prescribed a pure analgesic; 35{\%} prescribed subantiinflammatory doses of cyclooxygenase inhibiting NSAID. The remainder (64{\%}) recommended nonacetylated salicylates and cyclooxygenase inhibiting NSAID in doses large enough to achieve an antiinflammatory effect. Past participants in postgraduate rheumatology electives prescribed more costly regimens than those who had not participated (p = 0.05). When the case was altered to include a history of previous peptic ulcer, 44{\%} chose cyclooxygenase inhibiting NSAID with adjunctive prophylaxis against NSAID-induced gastropathy (e.g., misoprostol). When the complication was changed to renal insufficiency, recommendations for sulindac increased 3-fold over those for the uncomplicated case (34 vs 11{\%}), and were most common among more recent medical school graduates and past participants in rheumatology electives (p < 0.05 for both). The potential effects of educational and practice variables on the therapeutic strategies and costs of OA care in the community merit further systematic study.",
keywords = "analgesia, NSAID, osteoarthritis treatment, primary care physicians",
author = "Mazzuca, {S. A.} and Brandt, {K. D.} and Anderson, {S. L.} and Musick, {B. S.} and Barry Katz",
year = "1991",
language = "English",
volume = "18",
pages = "1593--1600",
journal = "Journal of Rheumatology",
issn = "0315-162X",
publisher = "Journal of Rheumatology",
number = "10",

}

TY - JOUR

T1 - The therapeutic approaches of community based primary care practitioners to osteoarthritis of the hip in an elderly patient

AU - Mazzuca, S. A.

AU - Brandt, K. D.

AU - Anderson, S. L.

AU - Musick, B. S.

AU - Katz, Barry

PY - 1991

Y1 - 1991

N2 - Predispositions to prescribe a pure analgesic, a cyclooxygenase inhibiting nonsteroidal antiinflammatory drug (NSAID) or a nonacetylated salicylate for a fictitious, uncomplicated case of osteoarthritis (OA) were surveyed in a sample of 152 community based primary care practitioners who had been characterized with respect to medical education and practice characteristics. Only 2 respondents (1%) prescribed a pure analgesic; 35% prescribed subantiinflammatory doses of cyclooxygenase inhibiting NSAID. The remainder (64%) recommended nonacetylated salicylates and cyclooxygenase inhibiting NSAID in doses large enough to achieve an antiinflammatory effect. Past participants in postgraduate rheumatology electives prescribed more costly regimens than those who had not participated (p = 0.05). When the case was altered to include a history of previous peptic ulcer, 44% chose cyclooxygenase inhibiting NSAID with adjunctive prophylaxis against NSAID-induced gastropathy (e.g., misoprostol). When the complication was changed to renal insufficiency, recommendations for sulindac increased 3-fold over those for the uncomplicated case (34 vs 11%), and were most common among more recent medical school graduates and past participants in rheumatology electives (p < 0.05 for both). The potential effects of educational and practice variables on the therapeutic strategies and costs of OA care in the community merit further systematic study.

AB - Predispositions to prescribe a pure analgesic, a cyclooxygenase inhibiting nonsteroidal antiinflammatory drug (NSAID) or a nonacetylated salicylate for a fictitious, uncomplicated case of osteoarthritis (OA) were surveyed in a sample of 152 community based primary care practitioners who had been characterized with respect to medical education and practice characteristics. Only 2 respondents (1%) prescribed a pure analgesic; 35% prescribed subantiinflammatory doses of cyclooxygenase inhibiting NSAID. The remainder (64%) recommended nonacetylated salicylates and cyclooxygenase inhibiting NSAID in doses large enough to achieve an antiinflammatory effect. Past participants in postgraduate rheumatology electives prescribed more costly regimens than those who had not participated (p = 0.05). When the case was altered to include a history of previous peptic ulcer, 44% chose cyclooxygenase inhibiting NSAID with adjunctive prophylaxis against NSAID-induced gastropathy (e.g., misoprostol). When the complication was changed to renal insufficiency, recommendations for sulindac increased 3-fold over those for the uncomplicated case (34 vs 11%), and were most common among more recent medical school graduates and past participants in rheumatology electives (p < 0.05 for both). The potential effects of educational and practice variables on the therapeutic strategies and costs of OA care in the community merit further systematic study.

KW - analgesia

KW - NSAID

KW - osteoarthritis treatment

KW - primary care physicians

UR - http://www.scopus.com/inward/record.url?scp=0026327814&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026327814&partnerID=8YFLogxK

M3 - Article

VL - 18

SP - 1593

EP - 1600

JO - Journal of Rheumatology

JF - Journal of Rheumatology

SN - 0315-162X

IS - 10

ER -