Use of NSAIDs, COX-2 inhibitors, and acetaminophen and associated coprescriptions of gastroprotective agents in an elderly population
| Autor: | Sheldon X. Kong, Michael A Marentette, Elham Rahme, Jacques LeLorier |
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| Rok vydání: | 2003 |
| Předmět: |
Male
medicine.medical_specialty Gastrointestinal Diseases medicine.medical_treatment Immunology Logistic regression Drug Prescriptions Cohort Studies Rheumatology Risk Factors Internal medicine medicine Immunology and Allergy Humans Pharmacology (medical) Cyclooxygenase Inhibitors Medical prescription Practice Patterns Physicians' Acetaminophen Aged Aged 80 and over Chemotherapy Cyclooxygenase 2 Inhibitors business.industry Confounding Anti-Inflammatory Agents Non-Steroidal Quebec Membrane Proteins Odds ratio Analgesics Non-Narcotic Confidence interval Surgery Isoenzymes Logistic Models Cyclooxygenase 2 Prostaglandin-Endoperoxide Synthases Female business medicine.drug Cohort study |
| Zdroj: | Arthritis and rheumatism. 47(6) |
| ISSN: | 0004-3591 |
| Popis: | Objectives To identify determinants of cyclooxygenase 2 (COX-2) inhibitor versus nonsteroidal antiinflammatory drug (NSAIDs) or acetaminophen prescription in seniors; and to compare gastroprotective agent coprescriptions. Methods Administrative medical records were obtained from the government of Quebec health insurance agency. Three cohorts were formed based on prescriptions at study entry: COX-2 inhibitors, NSAIDs, or acetaminophen. Logistic regressions were used to adjust for potential confounders. Results We identified 42,267 patients taking COX-2 inhibitors, 8,235 taking NSAIDs, and 19,716 taking acetaminophen. Determinants of utilizing COX-2 inhibitors versus NSAIDs and versus acetaminophen, respectively, include: female gender (odds ratio [OR] 1.47; 95% confidence interval [95% CI] 1.39–1.55 and OR 1.17; 95% CI 1.12–1.22); musculoskeletal diseases (OR 1.87; 95% CI 1.76–2.00 and OR 2.20; 95% CI 2.10–2.31); and prior gastrointestinal hospitalization (OR 1.82; 95% CI 1.19–2.78 and OR 0.77; 95% CI 0.64–0.92). Gastroprotective agent coprescriptions were lower with COX-2 inhibitors than NSAIDs: OR 0.53; 95% CI 0.48–0.58. Conclusions COX-2 inhibitors were more commonly used than NSAIDs in patients with musculoskeletal diseases and those with prior gastrointestinal hospitalizations. Adjusted odds ratios showed a 47% decrease in gastroprotective agent coprescriptions with COX-2 inhibitors compared with NSAIDs. |
| Databáze: | OpenAIRE |
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