Characteristics, diagnostic and symptom profile of patients receiving tegaserod in routine clinical practice in Canada.

OBJECTIVE This study was designed to assess the diagnostic and symptom profile of patients receiving tegaserod in routine clinical practice, and to identify their demographic characteristics, as well as the association between these characteristics and diagnosis. METHODS This prospective, observational study collected data from physicians on the symptoms and/or diagnosis, age range and gender for patients to whom they prescribed tegaserod. Details of the physician characteristics included whether they were a family physician or a specialist, and the region of Canada in which their practice was located. RESULTS A total of 500 patients were enrolled at 85 sites in Canada. The majority (85%) of the patients were enrolled by family physicians, and the remainder by community-based specialists. The patients were predominantly female (87%) and the highest percentages were in the 35-44 (23%) and 45-54 (25%) age groups. Nearly all patients (96%) were prescribed tegaserod on the basis of both symptoms and diagnosis. The most frequently reported symptoms were abdominal pain and/or discomfort (87%), bloating (80%) and constipation (75%). Most patients (57%) presented with all three of these symptoms. Constipation-predominant Irritable Bowel Syndrome (IBS-C) was the most common diagnosis (55%), followed by IBS alternating between constipation and diarrhea (IBS-A) (23%). Based on this, 67% of patients were given tegaserod strictly according to the label, although it was appropriately prescribed to 87%. CONCLUSIONS In Canada, tegaserod is prescribed to patients with symptoms of abdominal pain and/or discomfort, bloating and constipation. Most of them will also have a diagnosis of either IBS-C or IBS. It is generally being prescribed appropriately.

[1]  L. Chang,et al.  A randomised controlled trial assessing the efficacy and safety of repeated tegaserod therapy in women with irritable bowel syndrome with constipation , 2005, Gut.

[2]  F. Mearin,et al.  Bowel Habit Subtypes and Temporal Patterns in Irritable Bowel Syndrome: Systematic Review , 2005, The American Journal of Gastroenterology.

[3]  D. Drossman,et al.  A prospective assessment of bowel habit in irritable bowel syndrome in women: defining an alternator. , 2005, Gastroenterology.

[4]  A. Blum,et al.  Meta‐analysis: the treatment of irritable bowel syndrome , 2004, Alimentary pharmacology & therapeutics.

[5]  A. Roalfe,et al.  Prevalence of irritable bowel syndrome: a community survey. , 2004, The British journal of general practice : the journal of the Royal College of General Practitioners.

[6]  P. Whorwell,et al.  Tegaserod for the treatment of irritable bowel syndrome. , 2004, The Cochrane database of systematic reviews.

[7]  M. Crowell,et al.  Overlapping upper and lower gastrointestinal symptoms in irritable bowel syndrome patients with constipation or diarrhea , 2003, American Journal of Gastroenterology.

[8]  H. Yuen,et al.  An Asia-Pacific, double blind, placebo controlled, randomised study to evaluate the efficacy, safety, and tolerability of tegaserod in patients with irritable bowel syndrome , 2003, Gut.

[9]  X. Badia,et al.  Irritable bowel syndrome subtypes according to bowel habit: revisiting the alternating subtype , 2003, European journal of gastroenterology & hepatology.

[10]  D. Drossman,et al.  AGA technical review on irritable bowel syndrome. , 2002, Gastroenterology.

[11]  M. Lefkowitz,et al.  A randomized, double‐blind, placebo‐controlled trial of tegaserod in female patients suffering from irritable bowel syndrome with constipation , 2002, Alimentary pharmacology & therapeutics.

[12]  F. Pace,et al.  Tegaserod, a 5‐HT4 receptor partial agonist, relieves symptoms in irritable bowel syndrome patients with abdominal pain, bloating and constipation , 2001, Alimentary pharmacology & therapeutics.

[13]  R. Lipton,et al.  Epidemiology of constipation (EPOC) study in the United States: relation of clinical subtypes to sociodemographic features , 1999, American Journal of Gastroenterology.

[14]  S. Fullerton,et al.  Patient‐perceived severity of irritable bowel syndrome in relation to symptoms, health resource utilization and quality of life , 1997, Alimentary pharmacology & therapeutics.

[15]  O. Nyrén,et al.  Irritable bowel syndrome and dyspepsia in the general population: overlap and lack of stability over time. , 1995, Gastroenterology.

[16]  G. Longstreth,et al.  Irritable bowel-type symptoms in HMO examinees , 1993, Digestive Diseases and Sciences.

[17]  D. Drossman,et al.  The irritable bowel syndrome: review and a graduated multicomponent treatment approach. , 1992, Annals of internal medicine.

[18]  Roger Jones,et al.  Irritable bowel syndrome in the general population. , 1992, BMJ.

[19]  M. Farthing.  Treatment of irritable bowel syndrome , 1981, BMJ : British Medical Journal.

[20]  S. Wexner.  Clinical Patterns Over Time in Irritable Bowel Syndrome: Symptom Instability and Severity Variability , 2004, American Journal of Gastroenterology.

[21]  E. Irvine,et al.  Functional Gastrointestinal Disorders in Canada: First Population-Based Survey Using Rome II Criteria with Suggestions for Improving the Questionnaire , 2004, Digestive Diseases and Sciences.

[22]  Evidence-based position statement on the management of irritable bowel syndrome in North America , 2002, American Journal of Gastroenterology.