Changes in osteoarthritis management by general practitioners in the COX2-inhibitor era–concomitant gastroprotective therapy

Bouée, S.; Charlemagne, Agnès; Fagnani, Francis; Jeunne, Philippe Le; Sermet, Catherine; Naudin, F.; Lancry, Pierre-Jean

doi:10.1016/s1297-319x(03)00158-1

Cited by 19 publications

(9 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The data source was the 2006 BKL-Thales database 22,33–38. Physicians in the Thales panel compose a nationally representative sample, based on criteria of age, gender, and area of practice.…”

Section: Methodsmentioning

confidence: 99%

Mixed dyslipidemias in primary care patients in France

Laforest¹,

Ambegaonkar²,

Souchet³

et al. 2012

VHRM

View full text Add to dashboard Cite

ObjectiveTo determine the prevalence of single and mixed dyslipidemias among patients treated with statins in clinical practice in France.MethodsThis is a prospective, observational, cross-sectional, pharmacoepidemiologic study with a total of 2544 consecutive patients treated with a statin for at least 6 months.Main outcome measuresPrevalence of isolated and mixed dyslipidemias of low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and triglycerides among all patients and among patients at high cardiovascular risk; clinical variables associated with attainment of lipid targets/normal levels in French national guidelines.ResultsAt least one dyslipidemia was present in 50.8% of all patients and in 71.1% of high-risk patients. Dyslipidemias of LDL-C, HDL-C, and triglycerides were present in 27.7%, 12.4%, and 28.7% of all patients, respectively, and in 51.0%, 18.2%, and 32.5% of high-risk patients, respectively. Among all subjects with any dyslipidemia, 30.9% had mixed dyslipidemias and 69.4% had low HDL-C and/or elevated triglycerides, while 30.6% had isolated elevated LDL-C; corresponding values for high-risk patients were 36.8%, 58.9%, and 41.1%. Age, gender, body mass index and Framingham Risk Score >20% were the factors significantly associated with attainment of normal levels for ≥2 lipid levels.ConclusionsAt least one dyslipidemia persisted in half of all patients and two-thirds of high cardiovascular risk patients treated with a statin. Dyslipidemias of HDL-C and/or triglycerides were as prevalent as elevated LDL-C among high cardiovascular risk patients.

show abstract

Section: Methodsmentioning

confidence: 99%

Mixed dyslipidemias in primary care patients in France

Laforest¹,

Ambegaonkar²,

Souchet³

et al. 2012

VHRM

View full text Add to dashboard Cite

show abstract

“…GPs participating in the Thalès network are selected to be representative of the French GP population according to three main criteria, namely geographical area, age, and gender. Activity and prescription habits of the panel have also been compared a posteriori with national data and shown to be representative [26]. The database currently includes records for >1.6 million patients, routinely collected since 2002.…”

Section: Methodsmentioning

confidence: 99%

“…The database currently includes records for >1.6 million patients, routinely collected since 2002. The Thalès database has been demonstrated to be a reliable source of information in numerous previous studies in rheumatology [26–28] and in other fields of medicine [29–32]. …”

Section: Methodsmentioning

confidence: 99%

Validation of the adherence evaluation of osteoporosis treatment (ADEOS) questionnaire for osteoporotic post-menopausal women

Breuil¹,

Cortet²,

Cotte

et al. 2011

Osteoporos Int

View full text Add to dashboard Cite

SummaryWe developed and validated a specific 12-item questionnaire to evaluate adherence to oral antiresorptive medication by post-menopausal osteoporotic women in everyday practice. Over the following 9 months, an index of ≤16 was associated with an increase in the risk of treatment discontinuation of 1.69 and of 2.10 for new patients who had started treatment within the previous year.IntroductionAdherence to medication in osteoporosis is poor. The goal of this study was to develop and validate a disease-specific questionnaire to evaluate adherence to treatment of women with post-menopausal osteoporosis taking oral antiresorptive medication.MethodsA prototype adherence questionnaire with 45 items developed from patient interview, literature review, and physician opinion was evaluated in a sample of 350 post-menopausal women with osteoporosis treated in primary care. Item responses were matched against scores on the Morisky Medication Adherence Scale (MMAS). The most discriminant items were retained in the final questionnaire. Concurrent and predictive validity were assessed.ResultsTwelve items were associated with MMAS score at a probability level of 0.05. These were retained in the final questionnaire which provided an adherence index ranging from 0 to 22. An index of ≥20 was associated with a high probability of persistence and an index ≤ 16 with a high probability of treatment discontinuation in the following 9 months.ConclusionsThe ADEOS-12 is a simple patient-reported measure to determine adherence to osteoporosis treatments with good concurrent and discriminant validity. This is the first disease-specific adherence measure to have been developed for osteoporosis.Electronic supplementary materialThe online version of this article (doi:10.1007/s00198-011-1555-8) contains supplementary material, which is available to authorized users.

show abstract

“…One could partly explain these differences by some factors, like for example differences in the intensity or duration of the treated diseases (more severe and more chronic in rheumatologist's practice). However, the observed differences in term of coxibs’ prescription in the present study should be discussed, as several studies have shown that patients with gastrointestinal and/or cardiovascular risk factors were more likely to receive coxibs than classical NSAIDs [16,17].…”

Section: Discussionmentioning

confidence: 86%

“…Moreover, concomitant use of gastroprotective agents was related to a history of upper gastrointestinal disease in 78% of patients treated by coxib vs. 60% of patients receiving a classical NSAID. Finally, switch from a classical NSAID to a coxib was associated with 61% decrease in prescription of gastroprotective drugs [16]. Our work offers new data about the medical and social factors influencing coxibs’ prescription.…”

Section: Discussionmentioning

confidence: 96%

Coxibs: evolution of prescription's behaviour in France

Biga

Gony

Bourrel

et al. 2007

Fundamemntal Clinical Pharma

View full text Add to dashboard Cite

The aim of the present study was, first to characterize profiles of coxibs' prescribers [general practitioners (GPs) and rheumatologists] in 2002 in France and, secondly, to identify factors associated with modification of this profile 1 year later. All GPs and rheumatologists from Midi-Pyrenees, Aquitaine, Languedoc-Roussillon and Pays de Loire areas (South of France: 11 050 000 inhabitants) were included in the study. For each practitioner, we used data concerning all non-steroidal anti-inflammatory drugs (NSAIDs) including coxibs reimbursed during period 1 (P1; January-March 2002) and period 2 (P2; January-March 2003). The ratio between the number of coxibs' prescriptions and the total number of NSAIDs' prescriptions (including coxibs) was used to define the two profiles of prescribers, one with a low level of coxibs' prescriptions and another one with a high level of coxibs' prescriptions. Characteristics of practitioners and characteristics of their practices were compared according to this profile. In the second step, we investigated the characteristics (of practitioners and practices) associated with an increase in the level of coxibs' prescriptions in P2 for practitioners with a low level of coxibs' prescriptions in P1. Results are expressed as odds ratio with their 95% confidence intervals. A positive statistical link was found between a high level of coxibs' prescriptions, the speciality of rheumatologist or extra costs for consultation. In contrast, a negative association was observed with female gender or age below 44 years. No relationship was found with the status of referent. Concerning practices' characteristics of practitioners, there was a positive statistical link between a high ratio of coxibs' prescriptions and high co-prescriptions of gastroprotective agents and a negative association with a high number of acts, a high proportion of patients with chronic disabling diseases (CDD) or a high number of patients between 15 and 64 years. There was no statistical link with proportion of patients covered by Universal Medical Coverage (UMC) or aged more than 65 years. Among the factors involved in the increase in the ratio (between P1 and P2), no relationship was found with practitioners' characteristics. In contrast, some factors related to practices (level of gastroprotective co-prescriptions, number of acts, number of CDD patients) were related to a change in coxibs' prescriptions between P1 and P2. This study allowed to discuss some relationships between coxibs' prescription and practitioners' (age, gender, medical speciality or extra costs for consultation) or practices' (level of medical practice, patients' age, number of CDD patients or level of gastroprotective prescriptions) characteristics. In contrast, some other factors like the referent status or the number of patients with UMC are not related. Physicians, initially low prescribers of coxibs and increasing their coxibs' prescriptions during the period of our study, were those with a high level of gastroprotective prescriptions, a low num...

show abstract

Changes in osteoarthritis management by general practitioners in the COX2-inhibitor era–concomitant gastroprotective therapy

Cited by 19 publications

References 8 publications

Mixed dyslipidemias in primary care patients in France

Mixed dyslipidemias in primary care patients in France

Validation of the adherence evaluation of osteoporosis treatment (ADEOS) questionnaire for osteoporotic post-menopausal women

Coxibs: evolution of prescription's behaviour in France

Contact Info

Product

Resources

About