Healthy Skepticism Library item: 10973
Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.
Publication type: Journal Article
Klein D, MacDonald A, Drummond N, Cave A.
A qualitative study to identify factors influencing COXIB prescribed by family physicians for musculoskeletal disorders.
Fam Pract 2006 Dec; 23:(6):659-65
http://fampra.oxfordjournals.org/cgi/content/full/23/6/659
Abstract:
INTRODUCTION: Cyclo-oxygenase-2 inhibiting (COXIB) anti-inflammatories have been the drug class prescribed for a large number of cases of musculoskeletal (MSK) disorders in Canada over the past 5 years. The Alberta Improvements for MSK Disorders (AIMS) initiative sought to better understand the COXIB prescribing situation by funding several studies. The objective of this qualitative study was to determine the factors underlying primary care physicians’ medication prescribing behaviour during an office visit for an MSK disorder, with particular emphasis on the prescribing of COXIBs.
METHODS: The target respondents were Alberta primary care physicians chosen from a stratified random sample to meet a wide range of characteristics. Individual, semi-structured interviews were used to assess decision pathways in four real cases chosen by the physician. A total of 19 interviews were conducted and analysed using an analytic inductive approach.
RESULTS: Factors judged as being important to decision pathways in relation to COXIB prescribing for MSK disease included safety, patient characteristics, affordability to patients, availability of samples, drug company marketing practices, habit formation, time contstraints, previous clinical experience of doctors and/or patient with certain drugs and doctors’ perception of absolute versus relative risk.
Interpretation. Most physicians preferentially prescribed COXIBs subsequent to a complicated, multifactorial, but essentially patient-centred, decision-making process.
Keywords:
MeSH Terms:
Alberta/epidemiology
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
Arthritis, Rheumatoid/drug therapy
Cyclooxygenase 2 Inhibitors/therapeutic use*
Decision Making
Family Practice/standards
Family Practice/statistics & numerical data*
Female
Fibromyalgia/drug therapy
Humans
Interviews
Male
Musculoskeletal Diseases/drug therapy*
Musculoskeletal Diseases/epidemiology
Osteoarthritis/drug therapy
Physician's Practice Patterns/standards
Physician's Practice Patterns/statistics & numerical data*
Physicians, Family/statistics & numerical data
Qualitative Research
Research Design
Sprains and Strains/drug therapy
Substances:
Anti-Inflammatory Agents, Non-Steroidal
Cyclooxygenase 2 Inhibitors
