Table 1.
Prescribing Patterns for Initial Outpatient Visits with a Diagnosis of Acute Otitis Externa, by Clinician Specialty, Marketscan Commercial Claims and Encounters Database, United States, 2004–2010
| Percentage of Visits | ||||||||
|---|---|---|---|---|---|---|---|---|
| Specialty | 2004 (n = 60,188) |
2005 (n = 89,932) |
2006 (n = 89,708) |
2007 (n = 117,452) |
2008 (n = 160,226) |
2009 (n = 183,497) |
2010 (n = 206,258) |
Percentage Change, 2004–2010a |
| All specialties (n = 907,261) | ||||||||
| Topical onlyb | 60.4 | 61.3 | 61.7 | 61.1 | 62.2 | 63.6 | 65.3 | 4.9 (4.1, 5.7) |
| Any systemicb | 36.5 | 35.8 | 35.4 | 35.9 | 34.8 | 33.6 | 32.1 | −4.4 (−5.0, −3.8) |
| Opioid pain reliever | 9.0 | 8.8 | 8.9 | 9.1 | 8.4 | 7.8 | 7.3 | −1.7 (−2.0, −1.4) |
| NSAID pain reliever | 1.7 | 1.7 | 1.6 | 1.7 | 2.1 | 2.0 | 1.9 | 0.2 (0.0, 0.3) |
| Otolaryngologists (n = 57,567) | ||||||||
| Topical onlyb | 64.2 | 64.5 | 64.7 | 64.4 | 64.5 | 65.1 | 65.5 | 1.3 (−4.9, 7.5) |
| Any systemicb | 27.5 | 27.0 | 26.5 | 27.2 | 26.8 | 26.1 | 25.9 | −1.6 (−5.6, 2.4) |
| Opioid pain reliever | 9.5 | 10.1 | 9.1 | 10.0 | 9.6 | 8.2 | 8.9 | −0.6 (−3.0, 1.7) |
| NSAID pain reliever | 1.3 | 1.0 | 1.1 | 1.1 | 1.0 | 1.2 | 1.3 | 0.0 (−0.8, 0.9) |
| Pediatricians (n = 203,639) | ||||||||
| Topical onlyb | 71.3 | 72.3 | 74.0 | 73.3 | 75.1 | 76.4 | 78.3 | 7.0 (3.3, 10.7) |
| Any systemicb | 27.0 | 26.3 | 24.6 | 25.3 | 23.5 | 22.2 | 20.4 | −6.6 (−8.8, −4.4) |
| Opioid pain reliever | 3.3 | 3.0 | 2.9 | 2.7 | 2.2 | 2.1 | 2.0 | −1.3 (−2.0, −0.5) |
| NSAID pain reliever | 0.2 | 0.2 | 0.2 | 0.2 | 0.4 | 0.4 | 0.4 | 0.2 (−0.0, 0.4) |
| General practitioners (n = 399,974) | ||||||||
| Topical onlyb | 58.7 | 59.0 | 58.6 | 57.9 | 58.4 | 59.4 | 61.0 | 2.3 (0.1, 4.5) |
| Any systemicb | 38.5 | 38.1 | 38.6 | 39.1 | 38.7 | 37.8 | 36.3 | −2.2 (−4.0, −0.4) |
| Opioid pain reliever | 8.2 | 8.0 | 8.1 | 8.6 | 7.8 | 7.4 | 6.9 | −1.3 (−2.1, −0.5) |
| NSAID pain reliever | 2.1 | 2.1 | 1.9 | 2.1 | 2.5 | 2.5 | 2.3 | 0.2 (−0.2, 0.6) |
| Emergency department (n = 67,837) | ||||||||
| Topical onlyb | 40.2 | 43.3 | 42.0 | 44.6 | 46.2 | 47.2 | 48.7 | 8.5 (3.7, 13.4) |
| Any systemicb | 53.9 | 51.6 | 53.3 | 50.5 | 49.2 | 48.6 | 47.1 | −6.9 (−12.3, −1.5) |
| Opioid pain reliever | 35.4 | 33.8 | 33.8 | 32.7 | 29.9 | 28.3 | 26.4 | −9.1 (−13.4, −4.7) |
| NSAID pain reliever | 4.5 | 5.0 | 5.1 | 4.5 | 5.6 | 5.4 | 5.1 | 0.6 (−1.0, 2.2) |
| Other specialtiesc (n = 178,244) | ||||||||
| Topical onlyb | 58.6 | 59.1 | 60.0 | 58.9 | 61.8 | 64.1 | 65.7 | 7.0 (3.4, 10.7) |
| Any systemicb | 38.6 | 38.5 | 37.7 | 38.6 | 35.9 | 33.7 | 32.4 | −6.2 (−9.1, −3.3) |
| Opioid pain reliever | 7.5 | 8.1 | 8.5 | 8.6 | 7.7 | 7.1 | 6.5 | −1.0 (−2.3, 0.3) |
| NSAID pain reliever | 1.7 | 1.7 | 1.4 | 1.8 | 2.2 | 1.9 | 1.7 | 0.1 (−0.6, 0.7) |
Abbreviation: NSAID, nonsteroidal anti-inflammatory drug.
Percentage change: the difference and 95% confidence interval for percentage of visits resulting in prescription for the specified medication type from 2004 to 2010, calculated using Poisson regression.
The “topical only” and “any systemic” categories do not sum to 100 because a small proportion of visits received neither category of medication.
Other specialties: category includes specialties not classified elsewhere (eg, members of a multispecialty physician group or health care providers at an urgent care facility).