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The Impact of Socioeconomic and Clinical Factors on Purchase of Prescribed Analgesics Before and After Hysterectomy on Benign Indication

Daugbjerg, Signe B. MSc*,†; Brandsborg, Birgitte MD, PhD; Ottesen, Bent MD, DMSc; Diderichsen, Finn MD, DMSc§; Osler, Merete MD, DMSc*

doi: 10.1097/AJP.0b013e318285d26f
Original Articles

Objective: Pelvic pain is a primary symptom of women referred for hysterectomy. This study identified risk factors for purchase of prescribed analgesics before and after hysterectomy and examined purchase changes after hysterectomy, specifically focusing on socioeconomic effects.

Methods: Nearly all Danish women (n=13,420) with a hysterectomy on benign indication between 2004 and 2006 were included in a registry-based follow-up study. Information on prescription analgesic purchase was from the Danish National Prescription Registry. Factors associated with a purchase and associations between socioeconomic factors and changes in analgesic purchase were assessed.

Results: Analgesic purchase after hysterectomy was independently predicted by age below 35 or above 65 years, body mass index >29.9, high American Society of Anesthesiologists (ASA) score, uterus weight <300 g, comorbidity, and less than high school education. In this study, 15% of women initiated or increased analgesic purchase after hysterectomy, whereas 50% with a purchase before hysterectomy ceased buying afterward. Women with low socioeconomic status (SES) (assessed by education, employment, and income) were more likely to increase purchase of analgesics than women with high SES (odds ratio for less than high school vs. more than high school=1.58; 95% confidence interval, 1.31-1.91) and less likely to cease use than women with high SES (odds ratio=0.67; confidence interval, 0.52-0.86 for low vs. high education).

Discussion: These results suggest that purchase of analgesics after hysterectomy is related to preoperative factors. Compared with women with high SES, women with low SES had less favorable changes in analgesic purchase after hysterectomy.

*Research Centre for Prevention and Health, Capital Region of Denmark, Glostrup University Hospital, Glostrup

Department of Gynecology, Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen

Danish Pain Research Center and Department of Anesthesiology, Aarhus University Hospital, Aarhus

§Department of Social Medicine, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark

The authors declare no conflict of interest.

Reprints: Signe B. Daugbjerg, MSc, Research Centre for Prevention and Health, Capital Region of Denmark, Glostrup University Hospital, Nordre Ringvej 57, Building 84/85, DK-2600 Glostrup, Denmark (e-mail: sibeda01@regionh.dk).

Received February 10, 2012

Accepted January 2, 2013

© 2014 by Lippincott Williams & Wilkins