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Otolaryngol Head Neck Surg. 2013 Jul;149(1):118-25. doi: 10.1177/0194599813485360. Epub 2013 Apr 12.

Prescribing patterns of primary care physicians and otolaryngologists in the management of laryngeal disorders.

Author information

  • 1Duke University Medical Center, Durham, North Carolina 27710, USA. seth.cohen@duke.edu

Abstract

OBJECTIVE:

To examine how primary care physicians (PCPs) and otolaryngologists use proton pump inhibitors (PPIs), antibiotics, antihistamines, oral and inhaled steroids, and histamine 2 antagonists in the treatment of laryngeal disorders.

STUDY DESIGN AND SETTING:

Retrospective analysis of data from a large, national administrative US claims database.

SUBJECTS AND METHODS:

Patients with laryngeal disorders based on ICD-9-CM codes from January 1, 2004, to December 31, 2008, seen as an outpatient by a PCP, otolaryngologist, or both and continuously enrolled for 12 months were included. Pharmacy claims, age, gender, geographic location, comorbid conditions, provider type, and laryngeal diagnosis were collected. Random-effects logistic regression and multinomial logistic regression analyses were performed.

RESULTS:

Of approximately 55 million individuals, 135,973 had a laryngeal diagnosis, 12 months post-index date follow-up, and an outpatient encounter with a PCP, otolaryngologist, or both. Acute laryngitis was one of the most common reasons PCPs prescribed each medication class. Nonspecific dysphonia was the most common reason otolaryngologists prescribed each medication class. Patients seen by a PCP had a higher odds ratio for receiving an antibiotic and antihistamine, and patients seen by an otolaryngologist had a greater odds ratio for receiving a PPI and inhaled steroids. After adjusting for other variables in the model, the probability that a patient seen by a PCP would receive an antibiotic was .55 and a PPI .13. If seeing an otolaryngologist, it was .44 and .22, respectively.

CONCLUSION:

Differences exist regarding the prescribing patterns of PCPs and otolaryngologists in treating patients with laryngeal disorders.

KEYWORDS:

dysphonia; laryngeal disorders; medication; prescribing patterns; treatment; voice

PMID:
23585154
[PubMed - indexed for MEDLINE]
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