Literature DB >> 19006919

[Frequency of dizziness-related diagnoses and prescriptions in a general practice database].

Carsten Kruschinski1, Markus Kersting, Alf Breull, Michael M Kochen, Janka Koschack, Eva Hummers-Pradier.   

Abstract

INTRODUCTION: Dizziness can be due to multiple causes. However, the aetiology often remains unclear. At the same time, there is a lack of evidence-based treatment options. The aim of this study was to investigate the frequency of dizziness-related diagnoses, referrals and prescriptions in a general practice database.
METHODS: Data from computerized patient records of 138 general practices participating in the MedViP project were used for cross-sectional analysis of the time period April 2001 until December 2002. The identification of dizzy patients was performed via ICD-10 diagnoses, free text fields and medication issued for dizziness. Frequencies were counted and odds ratios calculated to describe associations between diagnoses and medication.
RESULTS: For the period of investigation, 10,971 patients (from a total of 317,042 documented patients) were given at least one diagnosis of dizziness (prevalence 3.4%; mean age 59 years, 67.2% female). In 80.2% of the cases dizziness was coded as a symptom (R42) rather than a discrete disease. Prescriptions for dizziness were rather uncommon. An analysis of ATC codes showed that 6.6% of all affected patients were prescribed a specific drug for dizziness, most frequently betahistine. Antiemetics were prescribed in 7.1%, and the homeopathic preparation "Vertigoheel" in 2.8% of the dizzy patients. Betahistine was significantly more often prescribed for "unspecified" dizziness, vestibular neuritis, and benign paroxysmal positional vertigo; but not for Meniere's disease. It was given less often in "other peripheral" and in central vertigo as well as in cases where the symptom was coded (R42). 3.9% of the dizzy patients had been referred to the neurologist (55.4%), ENT-specialist (30.5%) or to both specialists (14.1%).
CONCLUSIONS: The manner of coding and prescribing reflects both a symptom-orientated classification used by general practitioners and the limitation of treatment options.

Entities:  

Mesh:

Year:  2008        PMID: 19006919     DOI: 10.1016/j.zefq.2008.05.001

Source DB:  PubMed          Journal:  Z Evid Fortbild Qual Gesundhwes        ISSN: 1865-9217


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