The CADEUS study: burden of nonsteroidal anti-inflammatory drug (NSAID) utilization for musculoskeletal disorders in blue collar workers.
OBJECTIVE
The aim of this study was to compare patterns of utilization of NSAIDs for musculoskeletal disorders (MSD) by occupation in a general employed population.


METHODS
This was a secondary analysis of the CADEUS cohort study on 5651 actively employed patients, who submitted at least one claim for the reimbursement of a NSAID dispensation for a MSD between August 2003 and July 2004, in the French National Healthcare Insurance database. Questionnaires were sent to prescribing physicians to obtain diagnoses and the medical history, and to patients for their occupation, height and weight and smoking status. Multivariate logistic regression was used to study the determinants of a heavy use of NSAIDs defined as 'over four dispensations in one year with less than two months between any two'.


RESULTS
Factors associated with heavy use of NSAIDs were age (Odds ratio (OR): 1.8 (ten years), 95% confidence interval (CI): 1.6-1.9), osteoarthritis (versus back pain) (OR: 1.8, 95% CI: 1.5-2.1), body mass index (superior to 30) (OR: 1.8, 95% CI: 1.5-2.2), and occupation (blue collar versus white collar workers) (OR: 1.4, 95% CI: 1.2-1.6). Blue collar workers also had a 20% higher prevalence of 5-year history of dyspepsia. No difference was observed between sexes or in the use of COX-2 selective inhibitors between occupations.


CONCLUSIONS
Factors associated with occupational constraints that contribute to the severity of MSDs, may explain the heavier use of NSAIDs among blue collar workers in spite of a concurrent and past medical history of adverse reactions to this type of medication.
Rossignol
Michel
M
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada. rossignol@santepub-mtl.qc.ca
Abouelfath
Abdelilah
A
Lassalle
Regis
R
Merlière
Yvon
Y
Droz
Cécile
C
Bégaud
Bernard
B
Depont
Fanny
F
Moride
Yola
Y
Blin
Patrick
P
Moore
Nicholas
N
Fourrier-Réglat
Annie
A
D000328:Adult; D000367:Age Factors; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D017723:Drug Utilization Review; D004812:Epidemiologic Methods; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000188:drug therapy*; D009784:Occupational Diseases / Q000188:drug therapy* / Q000453:epidemiology; D009790:Occupations; D055656:Prescriptions; D017678:Sex Distribution; D055815:Young Adult
D000894:Anti-Inflammatory Agents, Non-Steroidal