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Assessing factors related to the pharmacologic management of laryngeal diseases and disorders

Authors

  • Seth M. Cohen MD, MPH,

    Corresponding author
    • Duke Voice Care Center, Division of Otolaryngology–Head and Neck Surgery, Duke University Medical Center, Durham, North Carolina, U.S.A.
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  • Jaewhan Kim PhD,

    1. Division of Public Health and Study Design and Biostatistics Center, University of Utah, Salt Lake City, Utah, U.S.A.
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  • Nelson Roy PhD, CCC-SLP,

    1. Department of Communication Sciences and Disorders, Division of Otolaryngology–Head and Neck Surgery, University of Utah, Salt Lake City, Utah, U.S.A.
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  • Mark Courey MD

    1. Duke Voice Care Center, Division of Otolaryngology–Head and Neck Surgery, Duke University Medical Center, Durham, North Carolina, U.S.A.
    2. Department of Otolaryngology–Head and Neck Surgery, University of California–San Francisco, San Francisco, California, U.S.A.
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  • This study was presented at the American Laryngological Association Meeting, Orlando, Florida, U.S.A., April 10–11, 2013.

  • This study was funded by the American Academy of Otolaryngology–Head and Neck Surgery and supported in part by funding from the National Institutes of Health grant 1KM1CA156723 (to J.K.).

  • The authors have no other funding, financial relationships, or conflicts of interest to disclose.

Send correspondence to Seth Cohen, MD, MPH, DUMC Box 3805, Durham, NC 27710. E-mail: seth.cohen@duke.edu

Abstract

Objectives/Hypothesis

To examine how age, gender, comorbidity, geography, provider type, and laryngeal pathology influence the use of pharmacological treatment in managing patients with laryngeal disorders.

Study Design

Retrospective analysis of data from a large, nationally representative, administrative, US claims database.

Methods

Patients with a laryngeal disorder based on International Classification of Diseases, Ninth Revision, Clinical Modification codes from January 1, 2004 to December 31, 2008, seen as an outpatient by a primary care physician (PCP), otolaryngologist, or both and continuously enrolled for 12 months were included. Data regarding pharmacy claims, age, gender, geographic location, comorbid conditions, provider type, and laryngeal diagnosis were collected. To identify factors that influenced whether a patient received a medication or not, a logistic regression was performed.

Results

Of almost 55 million individuals in the database, 258,705 had a laryngeal diagnosis 12 months post-index date follow-up and an outpatient encounter with a PCP, otolaryngologist, or both. A total of 135,973 (52.6%) unique patients, mean age 47.4 years (22.2 standard deviation [SD]), with 61.9% female, received a medication, and 122,732 (47.4%), mean age 47.4 years (19.8 SD), with 65.8% female, did not. Higher odds ratios for medication treatment were associated with PCPs versus otolaryngologists, acute laryngitis, the South region, and patients with comorbid conditions. Variable prescription patterns were also observed for age and gender.

Conclusions

Multiple factors are associated with the use of medical treatment for laryngeal disorders.

Level of Evidence

2b. Laryngoscope, 2013

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