[Frequency of dizziness-related diagnoses and prescriptions in a general practice database].
| Autor: | Kruschinski C; Institut für Allgemeinmedizin, OE5440, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625 Hannover. Kruschinski.Carsten@mh-hannover.de, Kersting M, Breull A, Kochen MM, Koschack J, Hummers-Pradier E |
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| Jazyk: | němčina |
| Zdroj: | Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen [Z Evid Fortbild Qual Gesundhwes] 2008; Vol. 102 (5), pp. 313-9. |
| DOI: | 10.1016/j.zefq.2008.05.001 |
| Abstrakt: | Introduction: Dizziness can be due to multiple causes. However, the aetiology often remains unclear. At the same time, there is a lack of evidence-based treatment options. The aim of this study was to investigate the frequency of dizziness-related diagnoses, referrals and prescriptions in a general practice database. Methods: Data from computerized patient records of 138 general practices participating in the MedViP project were used for cross-sectional analysis of the time period April 2001 until December 2002. The identification of dizzy patients was performed via ICD-10 diagnoses, free text fields and medication issued for dizziness. Frequencies were counted and odds ratios calculated to describe associations between diagnoses and medication. Results: For the period of investigation, 10,971 patients (from a total of 317,042 documented patients) were given at least one diagnosis of dizziness (prevalence 3.4%; mean age 59 years, 67.2% female). In 80.2% of the cases dizziness was coded as a symptom (R42) rather than a discrete disease. Prescriptions for dizziness were rather uncommon. An analysis of ATC codes showed that 6.6% of all affected patients were prescribed a specific drug for dizziness, most frequently betahistine. Antiemetics were prescribed in 7.1%, and the homeopathic preparation "Vertigoheel" in 2.8% of the dizzy patients. Betahistine was significantly more often prescribed for "unspecified" dizziness, vestibular neuritis, and benign paroxysmal positional vertigo; but not for Meniere's disease. It was given less often in "other peripheral" and in central vertigo as well as in cases where the symptom was coded (R42). 3.9% of the dizzy patients had been referred to the neurologist (55.4%), ENT-specialist (30.5%) or to both specialists (14.1%). Conclusions: The manner of coding and prescribing reflects both a symptom-orientated classification used by general practitioners and the limitation of treatment options. |
| Databáze: | MEDLINE |
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