Document Detail


Does age bias the aggressive treatment of elderly patients with rheumatoid arthritis?
MedLine Citation:
PMID:  15996058     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Age bias has been reported to result in undertreatment of elderly patients with various medical conditions. We investigated whether a similar bias exists in the treatment of elderly patients with rheumatoid arthritis (ELDRA) compared to matched younger controls (YRA). METHODS: We performed an analysis of our RA clinical research registry to determine whether any differences exist between ELDRA and YRA patients with respect to use of combination disease modifying antirheumatic drugs (DMARD), biologic agents, corticosteroids, and nonsteroidal antiinflammatory drugs (NSAID). We also determined whether any difference in clinical status could be identified. RESULTS: Forty-nine female ELDRA subjects (age > 70 yrs) with insurance were matched for sex, insurance status, and duration of disease to YRA subjects (< 60 yrs). No statistically significant difference was noted in number of DMARD currently in use (1.24 +/- 0.78 vs 1.24 +/- 0.69, p = 1.00), or number of patients using biologic agents (25 vs 30; p = 0.31), corticosteroids (16 vs 11; p = 0.26), or NSAID (26 vs 36; p = 0.06). ELDRA and YRA patients also reported similar pain (judged using a visual analog scale, VAS; 3.5 +/- 2.6 cm vs 3.4 +/- 2.2 cm), fatigue (VAS 3.2 +/- 2.7 cm vs 3.9 +/- 2.9 cm), global assessment (VAS 2.8 +/- 2.2 cm vs 3.5 +/- 2.6 cm), and Health Assessment Questionnaire disability scores (0.82 +/- 0.5 vs 0.73 +/- 0.5). CONCLUSION: In this cohort of elderly patients with RA, we detected no bias in the use of RA treatment compared with younger controls. Clinical RA measures also showed that these elderly patients with RA were faring at least as well as the younger controls; they were not relatively undertreated.
Authors:
Melanie J Harrison; Caroline A Kim; Miriam Silverberg; Stephen A Paget
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of rheumatology     Volume:  32     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-07-04     Completed Date:  2005-08-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  1243-8     Citation Subset:  IM    
Affiliation:
Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, New York, NY 10021, USA. harrisonm@hss.edu
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living
Adrenal Cortex Hormones / therapeutic use
Adult
Aged
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
Antirheumatic Agents / therapeutic use*
Arthritis, Rheumatoid / drug therapy*
Biological Therapy
Female
Humans
Middle Aged
Physician's Practice Patterns / statistics & numerical data*
Prejudice*
Registries
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Anti-Inflammatory Agents, Non-Steroidal; 0/Antirheumatic Agents

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