Drug use trends for arthritis and other rheumatic conditions and effect of patient's age on treatment choice.

Desai, Rishi J; Agarwal, Santosh J; Aparasu, Rajender R

BACKGROUND Little is known about the influence of the patient's age on selection of treatment for arthritis and other rheumatic conditions (AORCs). The aim of the present study was to examine drug use trends in patients with AORCs in ambulatory care and to study age-specific drug use. METHODS Data from the National Ambulatory Medical Care Survey and the outpatient department component of the National Hospital Ambulatory Medical Care Survey were used to examine ambulatory visits for AORCs during 2001-2005. Use of nonsteroidal anti-inflammatory drugs (NSAIDs), analgesics (narcotics and nonnarcotics), steroids, and disease-modifying antirheumatoid drugs (DMARDs) was measured as the proportion of visits that resulted in a prescription. Age-specific drug use trends were determined separately for adult (19-64 years) and for elderly (> or = 65 years) patients. RESULTS According to the national surveys, there were 208 million ambulatory visits for AORCs during the study period. Use of NSAIDs, analgesics, steroids, and DMARDs was found to be 33.3%, 23.5%, 15.7%, and 4.3%, respectively. Analgesic use increased from 18.3% in 2001 to 26.7% in 2005. DMARDs and NSAIDs were prescribed 1.2 times more to adult patients than to elderly patients. Steroids and analgesics were prescribed 1.3 and 1.2 times more, respectively, to elderly patients than to adult patients. LIMITATION The findings do not translate to population-based prevalence measures, as the unit of analysis was the patient visit. CONCLUSIONS NSAIDs remain the most frequently prescribed drug class for AORCs; however, there has been increased use of analgesics in recent years. The study findings suggest that the patient's age plays a role in the choice of drugs prescribed for AORCs.