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PHARMACOEPIDEMIOLOGY

Gender Differences in NSAID Use Among Older Adults with Osteoarthritis

Research Health Scientist, Health Services Research and Development, Durham Veterans Affairs Medical Center; Assistant Research Professor, Department of Medicine, Duke University Medical Center, Durham, NC

Frank M Ahern, PhD

Senior Research Associate, Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA

Carol H Gold, PhD

Senior Lecturer, Senior Research Assistant, Department of Biobehavioral Health, The Pennsylvania State University

Debra A Heller, PhD

Pharmacy Research Scientist, First Health Services Corporation, Harrisburg, PA; Adjunct Assistant Professor, Department of Biobehavioral Health, The Pennsylvania State University

Reprints: Kelli L Dominick PhD, Durham Veterans Affairs Medical Center, Health Services Research and Development (152), 508 Fulton St., Durham, NC 27705-3897, FAX 919/416-5839, domin004{at}mc.duke.edu

BACKGROUND: Nonsteroidal antiinflammatory drugs (NSAIDs) are the most commonly prescribed medications for the treatment of osteoarthritis (OA). Little is known about whether there are important gender differences in NSAID use among patients with OA.

OBJECTIVE: To examine gender differences in patterns of NSAID use among older adults (65 y) with OA.

METHODS: Subjects (n = 11 298) were members of a statewide prescription drug plan who responded to a health-related quality-of-life (HRQOL) survey in 1997 and had a physician diagnosis of OA. Gender differences in patterns of NSAID use were examined over a 2-year period.

RESULTS: Approximately one-third of the participants filled at least 1 NSAID prescription during the study. Women were significantly more likely to be prescribed an NSAID than men (37% vs. 30%), had a greater total days' supply of NSAIDs, and were more frequently prescribed NSAIDs with greater degrees of cyclooxygenase-2 selectivity. These gender differences persisted in statistical analyses controlling for demographic factors, HRQOL, and gastrointestinal (GI) risk factors.

CONCLUSIONS: Results of this study showed significant gender differences in patterns of NSAID use, and these differences were independent of the risk for GI adverse effects and self-reported symptoms. Further research is needed to examine reasons for these gender variations, as well as their impact on the quality of symptom management.

Key Words: gender, geriatrics, nonsteroidal antiinflammatory drugs, osteoarthritis

Published Online, September 5, 2003. www.theannals.com, DOI 10.1345/aph.1C418

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