title: Assessing factors related to the pharmacologic management of laryngeal diseases and disorders.
abstract: OBJECTIVE
  To examine how age, gender, comorbidity, geography, provider type, and laryngeal pathology influence the use of pharmacological treatment in managing patients with laryngeal disorders.
  
  
  METHODS
  Retrospective analysis of data from a large, nationally representative, administrative, US claims database.
  
  
  METHODS
  Patients with a laryngeal disorder based on International Classification of Diseases, Ninth Revision, Clinical Modification codes from January 1, 2004 to December 31, 2008, seen as an outpatient by a primary care physician (PCP), otolaryngologist, or both and continuously enrolled for 12 months were included. Data regarding pharmacy claims, age, gender, geographic location, comorbid conditions, provider type, and laryngeal diagnosis were collected. To identify factors that influenced whether a patient received a medication or not, a logistic regression was performed.
  
  
  RESULTS
  Of almost 55 million individuals in the database, 258,705 had a laryngeal diagnosis 12 months post-index date follow-up and an outpatient encounter with a PCP, otolaryngologist, or both. A total of 135,973 (52.6%) unique patients, mean age 47.4 years (22.2 standard deviation [SD]), with 61.9% female, received a medication, and 122,732 (47.4%), mean age 47.4 years (19.8 SD), with 65.8% female, did not. Higher odds ratios for medication treatment were associated with PCPs versus otolaryngologists, acute laryngitis, the South region, and patients with comorbid conditions. Variable prescription patterns were also observed for age and gender.
  
  
  CONCLUSIONS
  Multiple factors are associated with the use of medical treatment for laryngeal disorders.
authors.affiliation: Duke Voice Care Center, Division of Otolaryngology-Head and Neck Surgery, Duke University Medical Center, Durham, North Carolina, USA. seth.cohen@duke.edu
authors.forename: Seth M
authors.initials: SM
authors.lastname: Cohen
authors.forename: Jaewhan
authors.initials: J
authors.lastname: Kim
authors.forename: Nelson
authors.initials: N
authors.lastname: Roy
authors.forename: Mark
authors.initials: M
authors.lastname: Courey
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D005260:Female; D006801:Humans; D007818:Laryngeal Diseases / Q000188:drug therapy* / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012737:Sex Factors; D014481:United States / Q000453:epidemiology