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Patterns of analgesic and anti-inflammatory medicine use by Australian veterans

Pearson, Sallie-Anne; Ringland, C.; Kelman, Chris; Mant, A.; Lowinger, J.; Stark, H.; Nichol, G.; Day, Richard O; Henry, David A

Description

Background: We examined analgesic and anti-inflammatory medicine use by Australian veterans before and after the introduction of selective Cox-2 inhibitors. Methods: We studied cohorts of Gold Card-holding veterans using prescription data held by the Department of Veterans' Affairs for the period 1 July 1998 to 30 June 2004. Outcomes were volume dispensed, average daily quantity and cumulative incidence of use of paracetamol-containing and aspirin-containing medicines, non-selective and...[Show more]

dc.contributor.authorPearson, Sallie-Anne
dc.contributor.authorRingland, C.
dc.contributor.authorKelman, Chris
dc.contributor.authorMant, A.
dc.contributor.authorLowinger, J.
dc.contributor.authorStark, H.
dc.contributor.authorNichol, G.
dc.contributor.authorDay, Richard O
dc.contributor.authorHenry, David A
dc.date.accessioned2015-12-10T22:13:52Z
dc.identifier.issn1444-0903
dc.identifier.urihttp://hdl.handle.net/1885/49958
dc.description.abstractBackground: We examined analgesic and anti-inflammatory medicine use by Australian veterans before and after the introduction of selective Cox-2 inhibitors. Methods: We studied cohorts of Gold Card-holding veterans using prescription data held by the Department of Veterans' Affairs for the period 1 July 1998 to 30 June 2004. Outcomes were volume dispensed, average daily quantity and cumulative incidence of use of paracetamol-containing and aspirin-containing medicines, non-selective and Cox-2-selective non-steroidal anti-inflammatory drugs (NSAIDs), tramadol and dextropropoxyphene. Results: Overall, we found high levels of use of analgesic and anti-inflammatory medicines, which increased by 43% over the study period. Use of paracetamol-containing medicines was overtaken by NSAIDs in 1999/2000, corresponding to the introduction of the Cox-2-selective agents. Between 12 and 17% of Cox-2-selective medicine recipients were supplied amounts indicative of continuous use in relatively high doses and 51% of veterans received at least one relatively Cox-2-selective medicine (celecoxib, rofecoxib, meloxicam, diclofenac) by the end of the study period. Dextropropoxyphene use declined during the study and tramadol use increased 10-fold. Conclusion: This study shows very high levels of Cox-2 inhibitor use during the 6-year period. Cox-2-selective agents were more likely to be taken continuously and at higher doses than non-selective NSAIDs. This is relevant in view of the cardiovascular toxicity of this group of medicines. The study shows the value of using unit record dispensing data to assess drug use patterns. Linking dispensing records to hospital separation and mortality data will further enhance our ability to monitor drug safety.
dc.publisherBlackwell Science Asia
dc.sourceInternal Medicine Journal
dc.subjectKeywords: acetylsalicylic acid; analgesic agent; antiinflammatory agent; celecoxib; codeine; dextropropoxyphene; diclofenac; diflunisal; ibuprofen; indometacin; ketoprofen; meloxicam; naproxen; paracetamol; piroxicam; rofecoxib; tenoxicam; tiaprofenic acid; tramado Analgesics; Cox-2 inhibitors; Elderly; Non-steroidal anti-inflammatory medicines; Prescribing practice; Secondary health data
dc.titlePatterns of analgesic and anti-inflammatory medicine use by Australian veterans
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume37
dc.date.issued2007
local.identifier.absfor111706 - Epidemiology
local.identifier.ariespublicationu3962038xPUB195
local.type.statusPublished Version
local.contributor.affiliationPearson, Sallie-Anne, University of New South Wales (St Vincent's Hosp School)
local.contributor.affiliationRingland, C., University of New South Wales
local.contributor.affiliationKelman, Chris, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationMant, A., University of New South Wales
local.contributor.affiliationLowinger, J., New South Wales Therapeutic Advisory Group
local.contributor.affiliationStark, H., New South Wales Therapeutic Advisory Group
local.contributor.affiliationNichol, G., St.Vincent's Hospital
local.contributor.affiliationDay, Richard O, University of New South Wales
local.contributor.affiliationHenry, David A, University of Newcastle
local.description.embargo2037-12-31
local.bibliographicCitation.issue12
local.bibliographicCitation.startpage798
local.bibliographicCitation.lastpage805
local.identifier.doi10.1111/j.1445-5994.2007.01516.x
dc.date.updated2015-12-09T08:00:40Z
local.identifier.scopusID2-s2.0-36348967673
CollectionsANU Research Publications

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