title: Prescription patterns for children with juvenile idiopathic arthritis in Michigan Medicaid: a comparison by prescriber type.
abstract: BACKGROUND
  Due to a limited number and disparate distribution of pediatric rheumatologists in the US, a variety of physician types provide care to children with rheumatologic diseases. However, little is known about how that care may differ across prescribing physician groups. Our objective was to compare medication claims for children with juvenile idiopathic arthritis (JIA) by type of prescribing physician.
  
  
  METHODS
  We performed a retrospective cohort study of children with JIA using Michigan Medicaid data for 7/1/2005-6/30/2007, employing descriptive and bivariate analyses by age, medication type, and prescriber type.
  
  
  RESULTS
  Among 397 children, there was no difference in the frequency of medication claims for children with internist versus pediatric rheumatologist prescribers. Children with non-rheumatologist prescribers were less likely to have claims for disease modifying anti-rheumatic drugs (DMARDs) and biologic agents.
  
  
  CONCLUSIONS
  Differential use of DMARDs and biologic agents by rheumatologists indicates the importance of referring children with JIA for specialty care.
authors.affiliation: Division of Pediatric Rheumatology, Child Health Evaluation and Research Unit, University of Michigan, 6C15A NIB, 300 North Ingalls, Ann Arbor, MI 48109 USA.
authors.forename: Meredith P
authors.initials: MP
authors.lastname: Riebschleger
authors.affiliation: Division of Pediatric Rheumatology, Duke University, Durham, NC USA.
authors.forename: Heather A
authors.initials: HA
authors.lastname: Van Mater
authors.affiliation: Division of Pediatric Rheumatology, Child Health Evaluation and Research Unit, University of Michigan, 6C15A NIB, 300 North Ingalls, Ann Arbor, MI 48109 USA.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Cohn
authors.affiliation: Division of Pediatric Rheumatology, Child Health Evaluation and Research Unit, University of Michigan, 6C15A NIB, 300 North Ingalls, Ann Arbor, MI 48109 USA.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Clark
mesh_terms: D000293:Adolescent; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001171:Arthritis, Juvenile / Q000188:drug therapy* / Q000453:epidemiology; D001688:Biological Products / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D008484:Medicaid / Q000706:statistics & numerical data*; D008824:Michigan / Q000453:epidemiology; D010820:Physicians / Q000145:classification*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D055656:Prescriptions / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014481:United States; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products
keywords: Arthritis; Drug therapy; Juvenile rheumatoid; Physician’s practice patterns