A clinical audit of the prescribing of celecoxib and rofecoxib in Australian rural general practice

Abstract

Aims  The new cyclooxygenase‐2 (COX‐2) selective inhibitors, celecoxib (Celebrex^®) and rofecoxib (Vioxx^®), have been widely prescribed since their launch. No reviews currently appear in the literature of prescribing patterns in Australia. This paper describes a self‐audit of the clinical use of selective COX‐2 inhibitor therapy undertaken with rural general practitioners (GPs) in Australia.Methods  A structured audit form was developed and distributed to interested GPs. The form was self‐administered and focused on issues about COX‐2 inhibitors and the types of patients who were receiving them, e.g. indications, patient demographics, risk factors and drug interactions.Results  A total of 627 patients were recruited (569 celecoxib and 58 rofecoxib). A range of doses was prescribed. Osteoarthritis was the most common indication (68.1%). Risk factors known for the nonselective nonsteroidal anti‐inflammatory drugs were identified in 65.1% of patients, with the most common being advanced age, hypertension and previous peptic ulcer disease. Potential drug interactions were common. A variety of reasons for initiation of therapy was identified; these included perceived increased efficacy, safety and failure of other treatment.Conclusions  These results show that COX‐2 inhibitors are being prescribed for patients with multiple risk factors that may place the patient at increased risk of adverse drug reactions to a COX‐2 inhibitor. The perception of improved safety and efficacy was common and is of concern. Limitations of the study include the reliance on self‐reporting.