Therapeutic strategies distinguish community based primary care physicians from rheumatologists in the management of osteoarthritis

S. A. Mazzuca, K. D. Brandt, Barry Katz, W. Li, K. D. Stewart

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Using an osteoarthritis (OA) case study, we described the drug therapy that primary care physicians prescribe for uncomplicated OA of the hip, and for OA complicated by a history of gastropathy or renal insufficiency. To produce 'gold standard' criteria against which to interpret previous results, the same instrument was administered to 126 rheumatologists selected at random from the membership of the American College of Rheumatology. Virtually all rheumatologists prescribed nonsteroidal antiinflammatory drugs (NSAID); 76% specified doses large enough to have significant antiinflammatory effects. In contrast, 65% of the primary care physicians recommended NSAID therapy in a suboptimal antiinflammatory dose (p = 0.055 for the rheumatologist-primary care physician difference). For OA complicated by a history of either gastropathy or renal insufficiency, rheumatologists were more likely than primary care physicians to adopt a therapeutic strategy that did not inhibit prostaglandin synthesis (p < 0.001 for both). Differences also were noted in the ancillary therapies employed by the 2 groups for managing uncomplicated OA. Educational interactions between rheumatologists and primary care physicians could benefit by recognition of the differing perspectives on NSAID dosing, the avoidance of NSAID induced side effects, and ancillary therapies that appear to differentiate subspecialists and generalists.

Original languageEnglish
Pages (from-to)80-86
Number of pages7
JournalJournal of Rheumatology
Volume20
Issue number1
StatePublished - 1993

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Primary Care Physicians
Osteoarthritis
Anti-Inflammatory Agents
Hip Osteoarthritis
Renal Insufficiency
Therapeutics
Drug Therapy
Drug-Related Side Effects and Adverse Reactions
Pharmaceutical Preparations
Prostaglandins
Rheumatologists

Keywords

  • NSAID
  • osteoarthritis
  • primary care physicians
  • rheumatology

ASJC Scopus subject areas

  • Immunology
  • Rheumatology

Cite this

Therapeutic strategies distinguish community based primary care physicians from rheumatologists in the management of osteoarthritis. / Mazzuca, S. A.; Brandt, K. D.; Katz, Barry; Li, W.; Stewart, K. D.

In: Journal of Rheumatology, Vol. 20, No. 1, 1993, p. 80-86.

Research output: Contribution to journalArticle

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