Variation among rheumatologists in the use of prednisone and second-line agents for the treatment of rheumatoid arthritis

✍ Scribed by Lindsey A. Criswell; William J. Redfearn

• Publisher: John Wiley and Sons
• Year: 1994
• Tongue: English
• Weight: 496 KB
• Volume: 37
• Category: Article
• ISSN: 0004-3591
• DOI: 10.1002/art.1780370407

✦ Synopsis

To test for and estimate variation among rheumatologists in their prescribing of prednisone and second-line agents for the treatment of rheumatoid arthritis (RA), after taking into account the characteristics of their patients.

Methods. Multiple logistic regression incorporating random effects for rheumatologists, with adjustment for patient characteristics.

Results. Values for the likelihood-ratio statistic provided strong evidence of such variation. Randomeffect variance estimates showed that the variation is of great magnitude.

Conclusion. Even after patient characteristics have been taken into account, the data show that the rheumatologist may strongly influence the use of prednisone and second-line agents by a patient.

Many decisions have to be made about the use and timing of physical therapies, drug therapies, and surgery in the management of patients with rheumatoid arthritis (RA). Prednisone and second-line agents are frequently the subject of these decisions because there are many such agents, they are frequently used, and the disease is chronic. It is not yet clear how different clinical subgroups of RA patients respond to prednisone and the various second-line agents. In