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

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Cohen, SM; Kim, J; Roy, N; Courey, M

Published Date

  • July 2013

Published In

Volume / Issue

  • 149 / 1

Start / End Page

  • 118 - 125

PubMed ID

  • 23585154

Electronic International Standard Serial Number (EISSN)

  • 1097-6817

Digital Object Identifier (DOI)

  • 10.1177/0194599813485360


  • eng

Conference Location

  • England