Prescription patterns for children with juvenile idiopathic arthritis in Michigan Medicaid: a comparison by prescriber type

Pediatr Rheumatol Online J. 2014 Sep 5:12:38. doi: 10.1186/1546-0096-12-38. eCollection 2014.

Abstract

Background: Due to a limited number and disparate distribution of pediatric rheumatologists in the US, a variety of physician types provide care to children with rheumatologic diseases. However, little is known about how that care may differ across prescribing physician groups. Our objective was to compare medication claims for children with juvenile idiopathic arthritis (JIA) by type of prescribing physician.

Methods: We performed a retrospective cohort study of children with JIA using Michigan Medicaid data for 7/1/2005-6/30/2007, employing descriptive and bivariate analyses by age, medication type, and prescriber type.

Results: Among 397 children, there was no difference in the frequency of medication claims for children with internist versus pediatric rheumatologist prescribers. Children with non-rheumatologist prescribers were less likely to have claims for disease modifying anti-rheumatic drugs (DMARDs) and biologic agents.

Conclusion: Differential use of DMARDs and biologic agents by rheumatologists indicates the importance of referring children with JIA for specialty care.

Keywords: Arthritis; Drug therapy; Juvenile rheumatoid; Physician’s practice patterns.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Juvenile / drug therapy*
  • Arthritis, Juvenile / epidemiology
  • Biological Products / therapeutic use*
  • Child
  • Child, Preschool
  • Cohort Studies
  • Humans
  • Infant
  • Infant, Newborn
  • Insurance Claim Review / statistics & numerical data
  • Medicaid / statistics & numerical data*
  • Michigan / epidemiology
  • Physicians / classification*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Prescriptions / statistics & numerical data
  • Retrospective Studies
  • United States
  • Young Adult

Substances

  • Antirheumatic Agents
  • Biological Products