{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T20:50:28Z","timestamp":1761511828236},"reference-count":48,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2003,6,3]],"date-time":"2003-06-03T00:00:00Z","timestamp":1054598400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatism"],"published-print":{"date-parts":[[2003,6,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine the effects of physician specialty and comorbidities on cyclooxygenase 2\u2013selective nonsteroidal antiinflammatory drugs (NSAIDs; coxibs) utilization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Medical records of 452 patients from a regional managed care organization with \u22653 consecutive NSAID prescriptions from June 1998 to April 2001 were abstracted. Multivariable adjusted associations between coxib initiation and discontinuation and patient and provider characteristics were examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1,142 NSAID prescriptions were written over 9,398 total patient\u2010months of followup. Compared with patients seeing family or general practitioners, patients seeing rheumatologists (odds ratio [OR] 3.4, 95% confidence interval [95% CI] 2.1\u20135.7) and internists (OR 2.3, 95% CI 1.5\u20133.6) were significantly more likely to receive a coxib, as well as patients with a history of osteoarthritis (OR 2.6, 95% CI 1.7\u20133.8), gastrointestinal disease (OR 2.3, 95% CI 1.2\u20134.5), and congestive heart failure (OR 4.1, 95% CI 1.0\u201316.4). Although specialists were more likely than generalists to prescribe coxibs, only family or general practitioners were significantly more likely to selectively use coxibs among their patients with a history of gastrointestinal disease. Fifty\u2010four percent of NSAID prescriptions were discontinued, and coxibs were significantly less likely to be discontinued than were traditional NSAIDs (OR 0.6, 95% CI 0.5\u20130.8).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings suggest significantly greater, but perhaps less selective use of coxibs among specialists, even after accounting for important covariates. The initiation and discontinuation of coxibs was influenced by physician specialty and by patient risk factors.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.11117","type":"journal-article","created":{"date-parts":[[2003,6,4]],"date-time":"2003-06-04T10:07:21Z","timestamp":1054721241000},"page":"293-299","source":"Crossref","is-referenced-by-count":14,"title":["The effects of physician specialty and patient comorbidities on the use and discontinuation of coxibs"],"prefix":"10.1002","volume":"49","author":[{"given":"Fausto G.","family":"Patino","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeroan","family":"Allison","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Olivieri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Mudano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucia","family":"Juarez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharina","family":"Person","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ted R.","family":"Mikuls","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larry","family":"Moreland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stacey H.","family":"Kovac","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth G.","family":"Saag","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2003,6,3]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199906173402407"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780280613"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.287.3.337"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.3109\/03009749609097231"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780381103"},{"key":"e_1_2_5_7_2","first-page":"524","article-title":"Prescribing behaviors of family physicians in the treatment of osteoarthritis","volume":"24","author":"Holt WS","year":"1992","journal-title":"Fam Med"},{"key":"e_1_2_5_8_2","first-page":"408","article-title":"Trends in antirheumatic medication use among patients with rheumatoid arthritis, 1981\u20101996","volume":"253","author":"Ward MM","year":"1998","journal-title":"J Rheumatol"},{"key":"e_1_2_5_9_2","first-page":"1648","article-title":"Patterns of drug use in rheumatoid arthritis","volume":"27","author":"Berard A","year":"2000","journal-title":"J Rheumatol"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199407000-00021"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(98)00072-2"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.6.777"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.162.3.265"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-199803000-00003"},{"key":"e_1_2_5_15_2","first-page":"2142","article-title":"Nonsteroidal antiinflammatory drugs and cognitive decline in the elderly","volume":"22","author":"Saag KG","year":"1995","journal-title":"J Rheumatol"},{"key":"e_1_2_5_16_2","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-199819060-00001"},{"key":"e_1_2_5_17_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.20.1921"},{"key":"e_1_2_5_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(93)90392-3"},{"key":"e_1_2_5_19_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1993.00410040045007"},{"key":"e_1_2_5_20_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-121-4-199408150-00011"},{"key":"e_1_2_5_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780370407"},{"key":"e_1_2_5_22_2","first-page":"2283","article-title":"Differences in the use of second\u2010line agents and prednisone for treatment of rheumatoid arthritis by rheumatologists and non\u2010rheumatologists","volume":"24","author":"Criswell LA","year":"1997","journal-title":"J Rheumatol"},{"key":"e_1_2_5_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1790100503"},{"key":"e_1_2_5_24_2","volume-title":"Applied Logistic Regression","author":"Hosmer JDW","year":"1989"},{"key":"e_1_2_5_25_2","doi-asserted-by":"publisher","DOI":"10.2307\/2986113"},{"key":"e_1_2_5_26_2","volume-title":"IMS HEALTH Reports Cox\u20102 Drug Sales In US Surge 137% in Six Month Period","author":"IMS Health","year":"2000"},{"key":"e_1_2_5_27_2","volume-title":"Top products, July 2001","author":"IMS Health","year":"2001"},{"key":"e_1_2_5_28_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.262.19.2721"},{"key":"e_1_2_5_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1790100302"},{"key":"e_1_2_5_30_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1790110305"},{"key":"e_1_2_5_31_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.158.15.1596"},{"key":"e_1_2_5_32_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2001.016006351.x"},{"key":"e_1_2_5_33_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2001.016006422.x"},{"key":"e_1_2_5_34_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.1999.08168.x"},{"key":"e_1_2_5_35_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199804000-00007"},{"key":"e_1_2_5_36_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa012075"},{"key":"e_1_2_5_37_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780380816"},{"key":"e_1_2_5_38_2","first-page":"88","article-title":"The arthritic complaint in primary care: prevalence, related disability, and costs","volume":"3","author":"Spitzer WO","year":"1976","journal-title":"J Rheumatol"},{"key":"e_1_2_5_39_2","first-page":"811","article-title":"Musculoskeletal problems in the family practice setting: guidelines for curriculum design","volume":"14","author":"Kahl LE","year":"1987","journal-title":"J Rheumatol"},{"key":"e_1_2_5_40_2","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200002)43:2<370::AID-ANR17>3.0.CO;2-D"},{"key":"e_1_2_5_41_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2001.01380.x"},{"key":"e_1_2_5_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1386-5056(99)00020-9"},{"key":"e_1_2_5_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1070-3241(00)26009-4"},{"key":"e_1_2_5_44_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.294.6567.289"},{"key":"e_1_2_5_45_2","first-page":"31","article-title":"Medication review and documentation in physician office practice","volume":"3","author":"Jaski ME","year":"2000","journal-title":"Eff Clin Pract"},{"key":"e_1_2_5_46_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1990.tb01496.x"},{"key":"e_1_2_5_47_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2125.2000.00204.x"},{"key":"e_1_2_5_48_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4780030207"},{"key":"e_1_2_5_49_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a113284"}],"container-title":["Arthritis Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fart.11117","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/art.11117","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T02:42:43Z","timestamp":1695868963000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/art.11117"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,6,3]]},"references-count":48,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2003,6,15]]}},"alternative-id":["10.1002\/art.11117"],"URL":"https:\/\/doi.org\/10.1002\/art.11117","archive":["Portico"],"relation":{},"ISSN":["0893-7524","1529-0123"],"issn-type":[{"value":"0893-7524","type":"print"},{"value":"1529-0123","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003,6,3]]}}}