Prescribing pattern of general practitioners for osteoarthritis in primary care settings in Bolu, Turkey

OBJECTIVE: To assess the drug preferences of primary care physicians for osteoarthritis (OA) in comparison with the current guidelines, and their reflections in the cost of prescriptions.

METHODS: Data were collected from all primary health care centers in Bolu, Turkey, during November 2002 from patient polyclinic logbooks. Drugs prescribed were classified according to the Anatomical Therapeutic Chemical Classification system for comparison purposes. Gender, age, and health insurance of patients were analyzed for drug preferences and costs.

RESULTS: Forty-eight primary care physicians prescribed 1,047 drugs for 507 OA patients with total a cost of $10,254. Anti-inflammatory and antirheumatic products were the leading group accounting for 59.6% of the prescribed drugs, and 84.1% of the total expenditure. Paracetamol, the most commonly recommended in the guidelines, constituted 6.9% of all prescribed drugs and 0.9% of the total cost. Drug preferences showed a statistical difference among the health insurance types while drugs' cost showed statistical significance among the gender and health insurance types. Cyclooxygenase-2-specific inhibitors were the most commonly prescribed subgroup, constituting 23.2% of prescribed drugs and 62.6% of the total expenditure.

CONCLUSION: Paracetamol in practice was not the first-line drug preferred by primary care physicians. Drug prescription data showed that the preference of drugs was affected by health insurance types and the gender of patients in favor of expensive, new drugs. There is a need for improvement of drug prescriptions to reflect current recommendations and guidelines.