Prescribing behaviors of family physicians in the treatment of osteoarthritis.
BACKGROUND
Patients with osteoarthritis are frequently managed by family physicians. New evidence suggests that nonsteroidal anti-inflammatory drugs (NSAIDs) are no more effective than simple analgesics for treating osteoarthritis. The purpose of this study was to characterize the pharmacologic prescribing practices of family physicians for treatment of osteoarthritis.


METHODS
One hundred eleven Indian family physicians were asked to provide their initial treatment recommendations for a hypothetical patient who had uncomplicated osteoarthritis. Responses were analyzed and subsequently validated by an audit of actual cases managed by family physicians.


RESULTS
The response rate was 78%. Of those responding, 97% chose NSAIDs as their first line of therapy. Physicians were more than twice as likely to use anti-inflammatory doses of these agents as they were to use analgesic doses. There were no significant differences between the results of the written simulation and the actual case audit (P = .4216).


CONCLUSIONS
Family physicians generally treat osteoarthritis with NSAIDs, and they prescribe anti-inflammatory doses more than twice as often as analgesic doses. An audit of the actual practice behaviors of family physicians corroborated this prescribing pattern. This prescribing behavior may be inappropriate given evidence that simple analgesics are as effective as NSAIDs.
Holt
W S
WS
Department of Family Medicine, Indiana University School of Medicine.
Mazzuca
S A
SA
D000700:Analgesics / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005194:Family Practice; D006801:Humans; D010003:Osteoarthritis / Q000188:drug therapy*; D010818:Practice Patterns, Physicians'
D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal