[Frequency of dizziness-related diagnoses and prescriptions in a general practice database].
BACKGROUND
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.
Kruschinski
Carsten
C
Institut für Allgemeinmedizin, OE5440, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625 Hannover. Kruschinski.Carsten@mh-hannover.de
Kersting
Markus
M
Breull
Alf
A
Kochen
Michael M
MM
Koschack
Janka
J
Hummers-Pradier
Eva
E
D003430:Cross-Sectional Studies; D016208:Databases, Factual; D003937:Diagnosis, Differential; D004244:Dizziness / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012017:Referral and Consultation / Q000706:statistics & numerical data