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Persistent analgesic use and the association with chronic pain and other risk factors in the population—a longitudinal study from the Tromsø Study and the Norwegian Prescription Database

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

Analgesics are commonly used drugs. The long-term effectiveness is mostly unproven, while the risk of several serious adverse effects is well established. We aimed to estimate the prevalence and incidence of persistent analgesic use and the association with chronic pain and sociodemographic and comorbid risk factors.

Methods

The Tromsø Study is an epidemiological, prospective study of health and diseases. We linked the sixth wave (Tromsø 6, 2007–08, n = 12,981) with the Norwegian Prescription Database (NorPD, 2004–13). Persistent analgesic use was defined as the use of analgesics, i.e., either non-steroidal anti-inflammatory drugs, opioids or paracetamol, for ≥90 days with proportion-of-days-covered ≥40 %. The study design provided both cross-sectional and longitudinal data; a cohort of 11,905 persons was followed for 4.5 years.

Results

The prevalence of persistent analgesic use was 4 % in general and 10 % among those reporting chronic pain. The incidence rate of persistent analgesic use was 21 per 1000 person-years in general. Baseline chronic pain doubled the risk of incident persistent analgesic use (HR = 2.05, 95 % CI 1.80–2.33). The risk increased with increasing chronic pain severity, as measured by chronic pain duration, frequency, intensity, and number of body locations. Sociodemographic risk factors were older age, female sex, lower education, and most likely lower physical activity. Psychological distress was not a statistical significant risk factor.

Conclusions

This study showed a relatively low prevalence of persistent analgesic use and that the majority of persons reporting chronic pain do not use analgesics persistently.

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Acknowledgments

This study was funded by a grant from the Northern Norway Regional Health Authority (8709/SFP1092-13). We thank the participants of the Tromsø Study.

Authors’ contributions

PJS, KS, AS, CSN, and AEE planned the study. PJS conducted the analysis and wrote the draft and the final manuscript. KS, TW, CSN, and AEE aided in the analysis. All authors contributed in the interpretation of the results. All authors have read and approved the final manuscript.

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Authors and Affiliations

  1. Regional Medicines Information and Pharmacovigilance Center (RELIS), University Hospital of North Norway, P.O. Box 79, N-9038, Tromsø, Norway

    Per-Jostein Samuelsen

  2. Department of Community Medicine, UiT—The Arctic University of Norway, Tromsø, Norway

    Per-Jostein Samuelsen, Tom Wilsgaard & Anne Elise Eggen

  3. Tromsø Hospital Pharmacy, Tromsø, Norway

    Kristian Svendsen

  4. Department of Pain Management and Research, Division of Emergencies and Intensive Care, Oslo University Hospital, Oslo, Norway

    Audun Stubhaug & Christopher Sivert Nielsen

  5. Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway

    Audun Stubhaug

  6. Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway

    Christopher Sivert Nielsen

Authors
  1. Per-Jostein Samuelsen
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  2. Kristian Svendsen
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  3. Tom Wilsgaard
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  4. Audun Stubhaug
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  5. Christopher Sivert Nielsen
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  6. Anne Elise Eggen
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Correspondence to Per-Jostein Samuelsen.

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The authors declare that they have no competing interests.

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Samuelsen, PJ., Svendsen, K., Wilsgaard, T. et al. Persistent analgesic use and the association with chronic pain and other risk factors in the population—a longitudinal study from the Tromsø Study and the Norwegian Prescription Database. Eur J Clin Pharmacol 72, 977–985 (2016). https://doi.org/10.1007/s00228-016-2056-7

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  • DOI: https://doi.org/10.1007/s00228-016-2056-7

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