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

Meredith P Riebschleger1, Heather A Van Mater2, Lisa M Cohn1

  • 1Division of Pediatric Rheumatology, Child Health Evaluation and Research Unit, University of Michigan, 6C15A NIB, 300 North Ingalls, Ann Arbor, MI 48109 USA.

Pediatric Rheumatology Online Journal
|September 18, 2014
PubMed

Insights

Pediatric rheumatologists are scarce, leading to varied care for juvenile idiopathic arthritis (JIA). Non-specialist care was linked to less use of advanced medications like disease-modifying anti-rheumatic drugs (DMARDs) and biologics.

Area of Science:

  • Pediatric Rheumatology
  • Health Services Research

Background:

  • Limited pediatric rheumatologists in the US necessitate care from diverse physician types.
  • Care variations among different physician groups for pediatric rheumatologic diseases are not well understood.

Purpose of the Study:

  • To compare medication claims for children with juvenile idiopathic arthritis (JIA) based on the type of physician prescribing.

Main Methods:

  • Retrospective cohort study using Michigan Medicaid data (2005-2007).
  • Analysis included 397 children with JIA, examining medication claims by prescriber type (internist, pediatric rheumatologist, non-rheumatologist).

Main Results:

  • No significant difference in overall medication claim frequency between internists and pediatric rheumatologists.
  • Children with non-rheumatologist prescribers were less likely to receive disease-modifying anti-rheumatic drugs (DMARDs) and biologic agents.

Conclusions:

  • The observed differences in DMARD and biologic agent use highlight the importance of specialized pediatric rheumatology care.
  • Referral to pediatric rheumatologists is crucial for optimal management of JIA.
Abstract

Keywords:
ArthritisDrug therapyJuvenile rheumatoidPhysician’s practice patterns

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