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Related Experiment Videos

Prescribing for multiple sclerosis patients in general practice: a case-control study.

H L Tremlett1, D K Luscombe, C M Wiles

  • 1Welsh School of Pharmacy, Cardiff University, Cardiff, UK.

Journal of Clinical Pharmacy and Therapeutics
|November 28, 2001
PubMed
Summary
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Multiple sclerosis (MS) patients in Wales received nearly twice as many prescriptions from general practitioners (GPs) compared to controls. Prescribing patterns for MS patients often lacked evidence-based support for certain medications.

Area of Science:

  • Neurology
  • General Practice
  • Pharmacology

Background:

  • Understanding prescribing patterns for multiple sclerosis (MS) is crucial for optimizing patient care.
  • General practitioners (GPs) play a key role in managing MS patients in primary care settings.
  • Previous research has not fully elucidated Welsh GP prescribing habits for MS patients.

Purpose of the Study:

  • To analyze and compare the prescribing patterns of GPs for multiple sclerosis (MS) patients in Wales.
  • To contrast MS patient prescriptions with a matched control population based on age, gender, and GP surgery.

Main Methods:

  • Utilized anonymized data from the all-Wales General Practice Morbidity Database (GPMD) for 1996.
  • Included 220,538 patient years at risk, identifying 216 MS cases based on Read codes.

Related Experiment Videos

  • Matched MS cases with randomly selected control patients from the same GP practices.

    • Main Results:

    • MS patients received an average of 15 drugs versus 8 for controls (P < 0.0005).
    • Significantly higher prescriptions for MS patients included laxatives, diuretics, hypnotics, anxiolytics, antidepressants, antiepileptics, corticosteroids, oxybutynin, vitamin B12, and skeletal muscle relaxants.
    • Underutilization of 'MS-specific' drugs like cytotoxic immunosuppressants and amantadine was observed; no erectile dysfunction medication was prescribed.

    Conclusions:

    • MS patients are high users of prescribed medicines, with GPs prescribing nearly double the medications compared to controls.
    • Prescribing often aligned with evidence for symptom management (e.g., oxybutynin, baclofen) but lacked support for others (e.g., diuretics, vitamin B12).
    • Concerns raised regarding unsubstantiated corticosteroid use, subtherapeutic SSRI courses, and lack of sexual dysfunction medication in MS patients.