Relationship of clinical factors to the use of Cox-2 selective NSAIDs within an arthritis population in a large HMO.

Objective: To investigate the degree to which physicians use clinical factors to focus use of Cox-2 selective NSAIDs within an arthritis population.

Methods: Diagnostic codes in the medical records of a large group-model HMO in northern California with approximately 3 million members were examined to identify patients with either rheumatoid arthritis (RA) or non-RA (osteoarthritis or degenerative joint disease). RA and non-RA patients were stratified in deciles of relative risk for gastrointestinal (GI) complications according to patient characteristics identified on the Standardized Calculator of Risk for Events (SCORE) that were associated with use of Cox-2 selective NSAIDs.