USE OF CELECOXIB IMMEDIATELY POST MARKETING IN CANADA: ACUTE OR CHRONIC PAI N?

Main Article Content

Anita L Kozyrskyj
Colette Raymond
Amber Racher Racher

Keywords

CELECOXIB, POST MARKETING, diffusion of innovations theory, acute pain

Abstract

Objectives


The diffusion of innovations theory suggests that early users of innovations influence others. This study was undertaken to apply the diffusion of innovations theory to the prescribing of celecoxib and to determine if prescriber and patient characteristics differed amongst early use of celecoxib for acute pain versus chronic musculoskeletal conditions.


 Methods


Using Manitoba’s population-based prescription and health care databases, diffusion time from market availability to  first prescription  for  celecoxib  was  determined  for  each  prescriber.  The  diffusion  of prescribing curves for celecoxib in acute pain versus chronic musculoskeletal conditions were compared. Separately for acute and chronic conditions, the likelihood of being an early or late prescriber or user of celecoxib was determined according to physician factors (specialty and place of training) and patient demographics.  This  multivariate  analysis  was completed  using  polytomous  logistic  regression,  with majority prescribers as the reference.


 Results


The use of celecoxib for chronic musculoskeletal conditions demonstrated faster diffusion than for acute pain.  The  majority  of  early  use  of  celecoxib  was  for  chronic  conditions;  however  36%  of  first prescriptions were for acute pain, including the treatment of back pain and injuries. Early prescribers of celecoxib for acute pain were more likely than majority prescribers to be general practitioners (OR =2.24, 95%CI: 1.53-3.29) and have hospital affiliations (OR=1.54, 95%CI: 1.04-2.27). Early users of celecoxib for chronic conditions were less likely to be low income (OR=0.56, 95%CI: 0.35-0.91).


 Conclusions


Immediately after market release in Canada, celecoxib was commonly prescribed for the treatment of acute pain; these prescriptions were associated with general practitioners and hospital affiliation status.

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