Predictive factors of self-medicated analgesic use in Spanish adults: a cross-sectional national study
Tóm tắt
Analgesics are among the most commonly consumed drugs by the world populations. Within the broader context of self-medication, pain relief occupies a prominent position. Our study was to ascertain the prevalence of self-medication with analgesics among the Spanish population and to identify predictors of self-medication, including psychological disorders, psychological dysfunction, mental health status, and sociodemographic and health-related variables. We used individualized secondary data retrieved from the 2009 European Health Interview Survey (EHIS) for Spain to conduct a nationwide, descriptive, cross-sectional pharmacoepidemiology study on self-medication with analgesics among adults (individuals aged at least 16 years) of both genders living in Spain. A total of 7,606 interviews were analysed. The dichotomous dependent variables chosen were the answers “yes” or “no” to the question In the last 2 weeks have you taken the medicines not prescribed for you by a doctor for joint pain, headache, or low back pain?” Independent variables were sociodemographic, comorbidity, and healthcare resources. A total of 7,606 individuals reported pain in any of the locations (23.7%). In addition, analgesic consumption was self-prescribed in 23.7% (1,481) of these subjects. Forty percent (40.1%) of patients self-medicated for headache, 15.1% for low back pain, and 6.7% for joint pain. The variables significantly associated with a greater likelihood of self-medication of analgesics, independently of pain location were: age 16–39 years (2.36 < AOR < 3.68), higher educational level (1.80 < AOR <2.21), psychological disorders (1.56 < AOR < 1.98), and excellent/good perception of health status (1.74 < AOR < 2.68). In subjects suffering headache, self-prescription was associated with male gender (AOR 2.13) and absence of other comorbid condition (AOR 4.65). This pharmacoepidemiology study constitutes an adequate approach to analgesic self-medication use in the Spanish population, based on a representative nationwide sample. Self-prescribed analgesic consumption was higher in young people with higher educational level, higher income, smoker, and with psychological disorders and with a good perception of their health status independently of the location of pain.
Tài liệu tham khảo
Eccleston C: A normal psychology of everyday pain. Int J Clin Pract Suppl. 2013, 178: 47-50.
Langford RM: Pain management today-what have we learned?. Clin Rheumatol. 2006, 25: S2-S8.
Langley P: The prevalence, correlates and treatment of pain in the European Union. Curr Med Res Opin. 2011, 27: 463-480.
Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D: Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2006, 10: 287-333.
Leijon O, Wahlström J, Mulder M: Prevalence of self-reported neck-shoulder-arm pain and concurrent low back pain or psychological distress: time-trends in a general population, 1990–2006. Spine. 2009, 34: 1863-1868.
Fricker J: Pain in Europe report. Research project by NFO Worldgroup, Mundipharma International Limited, Cambridge, UK. 2003, [available] http://www.paineurope.com/painsurveys/pain-in-europe-survey/publication-for-download.html
Harker J, Reid KJ, Bekkering GE, Kellen E, Bala MM, Riemsma R, Worthy G, Misso K, Kleijnen J: Epidemiology of chronic pain in Denmark and Sweden. Pain Res Treat. 2012, 2012: 371248-
Strine TW, Hootman JM: US national prevalence and correlates of low back and neck pain among adults. Arthritis Rheum. 2007, 57: 656-665.
Mok LC, Lee IF: Anxiety, depression and pain intensity in patients with low back pain who are admitted to acute care hospitals. J Clin Nurs. 2008, 17: 1471-1480.
Haggman S, Maher CG, Refshauge KM: Screening for symptoms of depression by physical therapists managing low back pain. Phys Ther. 2004, 84 (12): 1157-1166.
Ryan A, Wilson S, Taylor A, Greenfield S: Factors associated with self-care activities among adults in the United Kingdom: a systematic review. BMC Public Health. 2009, 9: 96-
Hanna LA, Hughes CM: Public’s views on making decisions about over-the-counter medication and their attitudes towards evidence of effectiveness: a cross-sectional questionnaire study. Patient Educ Couns. 2011, 83: 345-351.
Häussinger C, Ruhl UE, Hach I: Health beliefs and over-the-counter product use. Ann Pharmacother. 2009, 43: 1122-1127.
Sawyer P, Bodner EV, Ritchie CS, Allman RM: Pain and pain medication use in community-dwelling older adults. Am J Geriatr Pharmacother. 2006, 4: 316-324.
Stosic R, Dunagan F, Palmer H, Fowler T, Adams I: Responsible self-medication: perceived risks and benefits of over-the-counter analgesic use. Int J Pharm Pract. 2011, 19: 236-245.
Hersh EV, Pinto A, Moore PA: Adverse drug interactions involving common prescription and over-the-counter analgesic agents. Clin Ther. 2007, 29: 2477-2497.
Roumie CL, Griffin MR: Over-the-counter analgesics in older adults: a call for improved labelling and consumer education Drugs Aging. 2004, 21: 485-498.
Wilcox CM, Cryer B, Triadafilopoulos G: Patterns of use and public perception of over-the-counter pain relievers: focus on nonsteroidal antiinflammatory drugs. J Rheumatol. 2005, 32: 2218-2224.
Carrasco-Garrido P, Jiménez-García R, Barrera-Hernandez V, Gil de Miguel A: Predictive factors of self-medicated drug use among the Spanish adult population. Pharmacoepidemiol Drug Saf. 2008, 17: 193-199.
Walsh TL, Homa K, Hanscom B, Lurie J, Sepulveda MG, Abdu W: Screening for depressive symptoms in patients with chronic spinal pain using the SF-36 Health Survey. Spine J. 2006, 6: 316-320.
Keeley P, Creed F, Tomenson B, Todd C, Borglin G, Dickens C: Psychosocial predictors of health-related quality of life and health service utilisation in people with chronic low back pain. Pain. 2008, 135: 142-150.
Oswald J, Salemi S, Michel BA, Sprott H: Use of the short-form-36 health survey to detect a subgroup of fibromyalgia patients with psychological dysfunction. Clin Rheumatol. 2008, 27: 919-921.
European Commission: Eurostat. European health interview survey (EHIS). Accessed: April 5, 2013. Available at: http://epp.eurostat.ec.europa.eu/portal/page/portal/microdata/european_health_interview_survey
Insituto Nacional de Estadistica: Encuesta Europea de Salud para España. Available at: http://www.ine.es/metodologia/t15/t153042009.pdf. Accessed: April 5, 2013
Ware JE, The SCD, MOS: 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992, 30: 473-483.
Turunen JH, Mäntyselkä PT, Kumpusalo EA, Ahonen RS: Frequent analgesic use at population level: prevalence and patterns of use. Pain. 2005, 115: 374-381.
Carrasco-Garrido P, Hernández-Barrera V, López de Andrés A, Jiménez-Trujillo I, Jiménez-García R: Sex-differences on self-medication in Spain. Pharmacoepidemiol Drug Saf. 2010, 19: 1293-1299.
Klemenc-Ketis Z, Hladnik Z, Kersnik J: A cross sectional study of sex differences in self-medication practices among university students in Slovenia. Coll Antropol. 2011, 35: 329-334.
Colás R, Muñoz P, Temprano R, Gómez C, Pascual J: Chronic daily headache with analgesic overuse: epidemiology and impact on quality of life. Neurology. 2004, 62: 1338-1342.
Chilet-Rosell E, Ruiz-Cantero MT, Sáez JF, Alvarez-Dardet C: Inequality in analgesic prescription in Spain. A gender development issue. Gac Sanit. 2013, 27: 135-142.
Krymchantowski AV, Moreira PF: Clinical presentation of transformed migraine: possible differences among male and female patients. Cephalalgia. 2001, 21: 558-566.
Al-Windi A, Elmfeldt D, Svärdsudd K: Determinants of drug utilisation in a Swedish municipality. Pharmacoepidemiol Drug Saf. 2004, 13 (2): 97-103.
Delaney JA, Biggs ML, Kronmal RA, Psaty BM: Demographic, medical, and behavioral characteristics associated with over the counter non-steroidal anti-inflammatory drug use in a population-based cohort: results from the Multi-Ethnic Study of Atherosclerosi. Pharmacoepidemiol Drug Saf. 2011, 20: 83-89.
Montgomery AJ, Bradley C, Rochfort A, Panagopoulou E: A review of self-medication in physicians and medical students. Occup Med. 2011, 61: 490-497.
Klemenc-Ketis Z, Hladnik Z, Kersnik J: Self-medication among healthcare and non-healthcare students at University of Ljubljana, Slovenia. Med Princ Pract. 2010, 19: 395-401.
Hagen K, Linde M, Steiner TJ, Stovner LJ, Zwart JA: Risk factors for medication-overuse headache: an 11-year follow-up study. The Nord-Trøndelag Health Studies. Pain. 2012, 153: 56-61.
Weingarten TN, Podduturu VR, Hooten WM, Thompson JM, Luedtke CA, Oh TH: Impact of tobacco use in patients presenting to a multidisciplinary outpatient treatment program for fibromyalgia. Clin J Pain. 2009, 25: 39-43.
Nielsen MW, Hansen EH, Rasmussen NK: Prescription and non-prescription medicine use in Denmark: association with socio-economic position. Eur J Clin Pharmacol. 2003, 59: 677-684.
Schiphorst Preuper HR, Reneman MF, Boonstra AM, Dijkstra PU, Versteegen GJ, Geertzen JH, Brouwer S: Relationship between psychological factors and performance-based and self-reported disability in chronic low back pain. Eur Spine J. 2008, 17: 1448-1456.
Schmid CW, Maurer K, Schmid DM, Alon E, Spahn DR, Gantenbein AR, Sandor PS: Prevalence of medication overuse headache in an interdisciplinary pain clinic. J Headache Pain. 2013, 14: 4-
Caamaño F, Alvarez R, Khoury M: The community pharmacists and their practice as health care providers. Gac Sanit. 2008, 22 (4): 385-
Hanna LA, Hughes CM: Pharmacists’ attitudes towards an evidence-based approach for over-the-counter medication. Int J Clin Pharm. 2012, 34 (1): 63-71.
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