Factors that influence prescribers in their selection and use of COX-2 selective inhibitors as opposed to non-selective NSAIDs

2.50
Hdl Handle:
http://hdl.handle.net/2336/13450
Title:
Factors that influence prescribers in their selection and use of COX-2 selective inhibitors as opposed to non-selective NSAIDs
Authors:
Gunnarsdottir, Anna I; Kinnear, Moira
Citation:
Pharm World Sci 2005, 27(4):316-20
Issue Date:
1-Aug-2005
Abstract:
OBJECTIVE: To identify factors that influence prescribers in their selection and use of cyclo-oxygenase-2 (COX-2) selective inhibitors as opposed to non-selective non-steroidal anti-inflammatory drugs (NSAIDs) and report the tendency to co-prescribe gastro-protection with these agents. SETTING: All 579 general practitioners (GPs) in one geographical area, Lothian, Scotland, UK. METHOD: Postal questionnaires; simple and factorial designed case series questionnaire. MAIN OUTCOME MEASURES: Categorisation of responses to clinical and non-clinical factors into highly, partially or not influential. The quantitative influence of the most prominent clinical factors on prescribing choice and the tendency of co-prescription of gastro-protection with these agents. RESULTS: Responses from 229 (40%) GPs suggested the following as most influential: Drug Evaluation Panel recommendations, Lothian Joint Formulary, local practice formulary, history of peptic ulcer disease (PUD), history of gastro-intestinal (GI) adverse effects with NSAIDs and advanced age. Advice from other physicians, patient demand, history of alcohol gastritis, history of gastro-oesophageal reflux disease, history of functional dyspepsia, concomitant use of low dose aspirin and concomitant use of gastro-protective agents were regarded to have moderate influence. Information directly from pharmaceutical industry and regular smoking were regarded as having weak influence. An 18% response to the factorial designed questionnaire using the most prominent clinical factors suggested that history of either GI adverse effects associated with non-selective NSAIDs or PUD resulted in more pronounced increase in the frequency (15%) of decision to prescribe COX-2 selective inhibitors than advanced age (10%). Concomitant use of low dose aspirin had little effect on GPs' decisions. The mean percentage of GPs choosing to co-prescribe gastro-protection was higher with non-selective NSAIDs (64%) than with COX-2 selective inhibitors (22%). CONCLUSION: Local authoritative guidance and history of GI complications highly influenced the GPs in their use and choice of either COX-2 selective inhibitors or non-selective NSAIDs. As expected the use of gastro-protection was more frequently chosen with non-selective NSAIDs than COX-2 selective inhibitors.
Description:
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field
Additional Links:
http://www.springerlink.com/content/757352556k224307

Full metadata record

DC FieldValue Language
dc.contributor.authorGunnarsdottir, Anna I-
dc.contributor.authorKinnear, Moira-
dc.date.accessioned2007-09-03T11:16:50Z-
dc.date.available2007-09-03T11:16:50Z-
dc.date.issued2005-08-01-
dc.date.submitted2007-09-03-
dc.identifier.citationPharm World Sci 2005, 27(4):316-20en
dc.identifier.issn0928-1231-
dc.identifier.pmid16228631-
dc.identifier.doi10.1007/s11096-005-2454-x-
dc.identifier.otherPHA12-
dc.identifier.urihttp://hdl.handle.net/2336/13450-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractOBJECTIVE: To identify factors that influence prescribers in their selection and use of cyclo-oxygenase-2 (COX-2) selective inhibitors as opposed to non-selective non-steroidal anti-inflammatory drugs (NSAIDs) and report the tendency to co-prescribe gastro-protection with these agents. SETTING: All 579 general practitioners (GPs) in one geographical area, Lothian, Scotland, UK. METHOD: Postal questionnaires; simple and factorial designed case series questionnaire. MAIN OUTCOME MEASURES: Categorisation of responses to clinical and non-clinical factors into highly, partially or not influential. The quantitative influence of the most prominent clinical factors on prescribing choice and the tendency of co-prescription of gastro-protection with these agents. RESULTS: Responses from 229 (40%) GPs suggested the following as most influential: Drug Evaluation Panel recommendations, Lothian Joint Formulary, local practice formulary, history of peptic ulcer disease (PUD), history of gastro-intestinal (GI) adverse effects with NSAIDs and advanced age. Advice from other physicians, patient demand, history of alcohol gastritis, history of gastro-oesophageal reflux disease, history of functional dyspepsia, concomitant use of low dose aspirin and concomitant use of gastro-protective agents were regarded to have moderate influence. Information directly from pharmaceutical industry and regular smoking were regarded as having weak influence. An 18% response to the factorial designed questionnaire using the most prominent clinical factors suggested that history of either GI adverse effects associated with non-selective NSAIDs or PUD resulted in more pronounced increase in the frequency (15%) of decision to prescribe COX-2 selective inhibitors than advanced age (10%). Concomitant use of low dose aspirin had little effect on GPs' decisions. The mean percentage of GPs choosing to co-prescribe gastro-protection was higher with non-selective NSAIDs (64%) than with COX-2 selective inhibitors (22%). CONCLUSION: Local authoritative guidance and history of GI complications highly influenced the GPs in their use and choice of either COX-2 selective inhibitors or non-selective NSAIDs. As expected the use of gastro-protection was more frequently chosen with non-selective NSAIDs than COX-2 selective inhibitors.en
dc.language.isoenen
dc.publisherKluwer Academic Publishersen
dc.relation.urlhttp://www.springerlink.com/content/757352556k224307en
dc.subject.meshAge Factorsen
dc.subject.meshAnti-Inflammatory Agents, Non-Steroidalen
dc.subject.meshCyclooxygenase 2 Inhibitorsen
dc.subject.meshDecision Makingen
dc.subject.meshDrug Utilizationen
dc.subject.meshFormulariesen
dc.subject.meshGastrointestinal Diseasesen
dc.subject.meshPhysician's Practice Patternsen
dc.subject.meshPhysicians, Familyen
dc.subject.meshScotlanden
dc.titleFactors that influence prescribers in their selection and use of COX-2 selective inhibitors as opposed to non-selective NSAIDsen
dc.typeArticleen
dc.format.digYES-
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