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Drug utilization in patients with OA: a population-based study

Drug utilization in patients with OA: a population-based study
Drug utilization in patients with OA: a population-based study
Objective. Patients with OA use different drugs in their search for relief. We aimed to study the prevalence of use and combinations of different medications for OA in a population-based cohort of OA patients in Catalonia, Spain, while characterizing users of each of the drugs available, with a particular focus on cardiovascular risk factors.

Methods. Data were obtained from the Sistema d‘Informació per al Desenvolupament de l‘Investigació en Atenció Primària (SIDIAP) database, which includes electronic medical records and pharmacy invoice data for >5 million people from Catalonia. Study participants were those with a clinical diagnosis of OA in 2006–10. Drugs studied included oral and topical NSAIDs, analgesics (paracetamol, metamizole), opioids (tramadol, fentanyl), cyclooxygenase 2 (COX-2) inhibitors and symptomatic slow-acting drugs in OA. Drug utilization was described using medication possession ratios (MPRs), equivalent to the proportion of days covered with the drug of interest. The annual incidence of new users in the first year after OA diagnosis from 2006 to 2010 was estimated for all studied drugs among newly diagnosed OA patients using Poisson regression.

Results. We identified 238 536 study participants. The most common regimen of treatment consisted of at least three drugs (53.9% of patients). The drugs most frequently used regularly (MPR ?50%) were chondroitin (21.2%), glucosamine (15.8%) and oral NSAIDs (14.4%). The incidence of the use of opioids, COX-2 inhibitors and chondroitin increased over the 5 year period, whereas all others decreased.

Conclusion. Drug combinations are common in the treatment of OA patients, who are thus exposed to potential drug interactions, with unknown impacts on their health. The increasing use of opioids and COX-2 inhibitors is noteworthy because of the potential impact on safety and costs.
osteoarthritis, pharmaceutical therapy, population-based cohort, Catalonia, pharmacoepidemiology, drug utilization, electronic health records
1462-0324
860-867
Wilson, N.
d3ba55bb-6cd1-4037-903d-a8b395b7aec3
Sanchez-Riera, L.
ba742e36-b0fa-4c44-a447-7655d4dd4c28
Morros, R.
5146cf41-5c74-4400-a221-e3803358f65b
Diez-Perez, A.
19f89c53-003a-469c-92ac-69b0b979f3ec
Javaid, M.K.
51d3310b-032e-4c15-83ac-b878bce090f3
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Arden, N.K.
23af958d-835c-4d79-be54-4bbe4c68077f
Prieto-Alhambra, D.
19a5643f-5969-4c0e-b6a9-863fb9e9d1c7
Wilson, N.
d3ba55bb-6cd1-4037-903d-a8b395b7aec3
Sanchez-Riera, L.
ba742e36-b0fa-4c44-a447-7655d4dd4c28
Morros, R.
5146cf41-5c74-4400-a221-e3803358f65b
Diez-Perez, A.
19f89c53-003a-469c-92ac-69b0b979f3ec
Javaid, M.K.
51d3310b-032e-4c15-83ac-b878bce090f3
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Arden, N.K.
23af958d-835c-4d79-be54-4bbe4c68077f
Prieto-Alhambra, D.
19a5643f-5969-4c0e-b6a9-863fb9e9d1c7

Wilson, N., Sanchez-Riera, L., Morros, R., Diez-Perez, A., Javaid, M.K., Cooper, C., Arden, N.K. and Prieto-Alhambra, D. (2015) Drug utilization in patients with OA: a population-based study. Rheumatology, 54 (5), 860-867. (doi:10.1093/rheumatology/keu403). (PMID:25339639)

Record type: Article

Abstract

Objective. Patients with OA use different drugs in their search for relief. We aimed to study the prevalence of use and combinations of different medications for OA in a population-based cohort of OA patients in Catalonia, Spain, while characterizing users of each of the drugs available, with a particular focus on cardiovascular risk factors.

Methods. Data were obtained from the Sistema d‘Informació per al Desenvolupament de l‘Investigació en Atenció Primària (SIDIAP) database, which includes electronic medical records and pharmacy invoice data for >5 million people from Catalonia. Study participants were those with a clinical diagnosis of OA in 2006–10. Drugs studied included oral and topical NSAIDs, analgesics (paracetamol, metamizole), opioids (tramadol, fentanyl), cyclooxygenase 2 (COX-2) inhibitors and symptomatic slow-acting drugs in OA. Drug utilization was described using medication possession ratios (MPRs), equivalent to the proportion of days covered with the drug of interest. The annual incidence of new users in the first year after OA diagnosis from 2006 to 2010 was estimated for all studied drugs among newly diagnosed OA patients using Poisson regression.

Results. We identified 238 536 study participants. The most common regimen of treatment consisted of at least three drugs (53.9% of patients). The drugs most frequently used regularly (MPR ?50%) were chondroitin (21.2%), glucosamine (15.8%) and oral NSAIDs (14.4%). The incidence of the use of opioids, COX-2 inhibitors and chondroitin increased over the 5 year period, whereas all others decreased.

Conclusion. Drug combinations are common in the treatment of OA patients, who are thus exposed to potential drug interactions, with unknown impacts on their health. The increasing use of opioids and COX-2 inhibitors is noteworthy because of the potential impact on safety and costs.

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More information

Accepted/In Press date: 13 August 2014
Published date: May 2015
Keywords: osteoarthritis, pharmaceutical therapy, population-based cohort, Catalonia, pharmacoepidemiology, drug utilization, electronic health records
Organisations: MRC Life-Course Epidemiology Unit

Identifiers

Local EPrints ID: 378039
URI: http://eprints.soton.ac.uk/id/eprint/378039
ISSN: 1462-0324
PURE UUID: aa7bb153-d0a1-44cf-8111-57378db118fe
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 25 Jun 2015 10:51
Last modified: 18 Mar 2024 02:45

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Contributors

Author: N. Wilson
Author: L. Sanchez-Riera
Author: R. Morros
Author: A. Diez-Perez
Author: M.K. Javaid
Author: C. Cooper ORCID iD
Author: N.K. Arden
Author: D. Prieto-Alhambra

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