Biomedical subjects

Emmeline Watkins

Publications and source records attributed to Emmeline Watkins.

2 recordsLinked to original sources

PubMed2006

The impact of NSAID or COX-2 inhibitor use on the initiation of antihypertensive therapy.

PURPOSE: The objective of this study was to quantify the associations between NSAIDs and COX-2 inhibitors and risk for initiating antihypertensive therapy. METHODS: We conducted a population-based case-control study in a large, integrated health system in the Midwestern United States. Cases (N = 23 562) were new users of antihypertensive therapy from 1, July 1997, through 31, January 2003. Controls (N = 23 562) were randomly selected and matched to cases on age, copay, medical care utilization, sex, and index date. The main outcome measures were exposure to NSAIDs and COX-2 inhibitors. RESULTS: Recent prescription NSAID use was associated with an increased risk for initiation of antihypertensive therapy (odds ratio (OR) = 1.6, 95%CI 1.5, 1.7) as were selective COX-2 inhibitors (OR = 1.8, 95%CI 1.6, 2.1). After adjusting for age, sex, co-payment, race, and exposure to other NSAIDs/COX-2, each non-selective NSAID (diclofenac, ibuprofen, indomethacin, naproxen, oxaprozin) was associated with an increased risk of antihypertensive therapy initiation, with ORs ranging from 1.4 to 1.8. Recent users of COX-2 inhibitors had an increased risk of initiating antihypertensive therapy, regardless of specific drug (celecoxib adjusted OR = 1.7 (95%CI 1.3, 2.1); rofecoxib adjusted OR = 1.7 (95%CI 1.4, 1.9)). CONCLUSIONS: A consistent increased risk of initiation of antihypertensive therapy was observed among recent users of NSAIDs and COX-2 inhibitors. Unlike previous studies, the results indicate that the effects of rofecoxib and celecoxib are equivalent.

Drug-Related Side Effects and Adverse Reactions↗

PubMed2006

Silent pain sufferers.

OBJECTIVE: To evaluate the proportion and characteristics of patients with chronic pain who do not seek treatment and assess whether these patients have unmet pain care needs. PATIENTS AND METHODS: We performed a cross-sectional survey of residents of Olmsted County, Minnesota, from March through June 2004, with additional visit and diagnosis data from the Rochester Epidemiology Project database. Study participants were a random, population-based sample of eligible adult (>30 years) residents of Olmsted County with at least 1 visit to a local health care facility in the past 3 years. RESULTS: Of the 5897 eligible participants, 3575 people (60.6%) responded. Of the respondents who reported pain of more than 3 months' duration, 497 (22.4%) of the 2211 patients stated that they had not informed their physician about their pain. Of these silent sufferers, 70.6% (351/497) reported having moderate or severe pain, 49.2% (243/497) reported having frequent pain (>8 days per month), and 40.6% (202/497) met both criteria. Silent sufferers also reported that pain interfered with their general activity and sleep to a level only slightly less than the chronic pain sufferers who reported discussing their pain with a physician. Silent sufferers made an average of 5.2 ambulatory physician visits per year, which was less than those who sought physician help for their pain (8.6 ambulatory visits per year; P < .001). Men and younger participants were more likely to be silent about their pain (P < .001). CONCLUSION: More than 1 in 5 people with chronic pain did not seek physician care for their pain. This group is unknown to physicians and therefore represents an unreported patient group with an unmet need for pain care.

Adaptation, Psychological↗