Is there an interaction between self-rated health and medication with analgesics and hypnotics in the prediction of disability pension?
OBJECTIVE
Several studies have shown that self-rated health (SRH) is associated with drug use. The aim of this study was to investigate the possible interaction between SRH and use of analgesics and hypnotics and its ability to predict disability pension.


METHODS
In 1974-78. complete birth-year cohorts of middle-aged male residents in Malmö, Sweden, were invited to a health screening, and the cohort in this study comprised 5,798 men with complete data followed up for 11 years.


RESULTS
At inclusion, 27% rated their health as less than perfect, 11% used analgesics, 3% used hypnotics and, during follow-up. 12% received a disability pension. The adjusted hazard ratios of disability pension were 3.1 (CI: 2.6, 3.6) for those who had rated their health as less than perfect and 2.7 (2.3, 3.2) for subjects who used analgesics and/or hypnotics. For subjects with the combined risk of poor SRH and medication, the hazard ratio was 5.5 (4.6, 6.5). The granting of disability pension attributable to the interaction between poor SRH and medication was estimated at 47%, which was statistically significant.


CONCLUSIONS
Disability pension among middle-aged men was associated with self-rated health as well as medication and clear evidence of synergism between the two factors was found, while there were no indications of medication acting as a causal link between poor SRH and disability pension. Several mechanisms may contribute to the findings, but the information gained may be used as means to identify those at risk for disability pension.
Månsson
Nils-Ove
NO
Department of Community Medicine, Lund University, Malmö University Hospital, Malmö, Sweden. nils-ove.mansson@smi.mas.lu.se
Merlo
Juan
J
Ostergren
Per-Olof
PO
D000293:Adolescent; D000328:Adult; D000700:Analgesics / Q000627:therapeutic use*; D001294:Attitude to Health; D015331:Cohort Studies; D006233:Persons with Disabilities / Q000523:psychology / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy* / Q000523:psychology*; D010415:Pensions / Q000706:statistics & numerical data*; D012307:Risk Factors; D012649:Self Concept; D013548:Sweden / Q000453:epidemiology
D000700:Analgesics; D006993:Hypnotics and Sedatives