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Rheumatology (Oxford). 2008 Jul;47(7):1061-4. doi: 10.1093/rheumatology/ken193. Epub 2008 May 22.

Changing patterns of medication use in patients with rheumatoid arthritis in a Medicaid population.

Author information

  • 1Department of Preventive Medicine, Vanderbilt University School of Medicine, 1500 21st Avenue, 2600 VAV, Nashville, TN 37212, USA. carlos.grijalva@vanderbilt.edu

Abstract

OBJECTIVE:

To examine changes in patterns of medication utilization in patients with RA.

METHODS:

Data from Tennessee Medicaid (TennCare) databases (1995-2004) were used to identify adults with both a diagnosis of RA and at least one DMARD prescription each year. Annual age-specific utilization of DMARDs, glucocorticoids, NSAIDs and narcotics was measured on the last day of each year to determine the point prevalence of use of these agents.

RESULTS:

Records from 23 342 patients with treated RA were analysed. Most patients were females (78%) and white (74%). The median age was 57 yrs (interquartile range: 48-65). The proportion of patients who had a current DMARD prescription on the index date increased from 62% in 1995 to 71% in 2004 (P < 0.001). MTX was the most commonly used DMARD. By the end of 2004, 22% of patients had a current prescription for a biologic, and etanercept represented 51% of all biologic therapies. During the study period, the overall utilization of glucocorticoids decreased from 46% to 38% (P < 0.001), whereas NSAID utilization increased from 33% to 38% (P < 0.001), and use of narcotics increased from 38% to 55% (P < 0.001). A secondary analysis that identified RA patients based on diagnosis codes alone, showed similar patterns, but lower DMARD utilization which increased from 33% to 52% overall and from 0% to 16% for biologics.

CONCLUSIONS:

The utilization of DMARDs increased in TennCare patients with RA, and by 2004, use of biologics was substantial. Although glucocorticoid utilization decreased, use of both NSAIDs and narcotics increased.

PMID:
18499716
[PubMed - indexed for MEDLINE]
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