title: Young adults' medicine use for headache: the combined effect of socioeconomic position and perceived stress, and the contribution of sense of coherence.
abstract: BACKGROUND
  Over-the-counter analgesic (OTCA) use is increasingly common and may have potential harmful side effects. The primary reason for using analgesics is headache symptoms. Whether OTCA use for headache is sensitive to psychosocial and social circumstances is an understudied topic.
  
  
  OBJECTIVE
  The purpose of this study was to examine the combined effect of socioeconomic position (SEP) and perceived stress on OTCA use for headache. An additional objective was to determine whether sense of coherence (SOC) modifies the association.
  
  
  METHODS
  Data derived from the cross-sectional "Danish Lifestyle and Medicine Use Study," 2009. The study population consisted of men and women ages 25-44 years (n = 955). The dependent variable was OTCA use for headache within the past 14 days. The independent variables were SEP, perceived stress, and SOC. Gender, headache prevalence, and response method were included as covariates. Associations were examined by means of logistic regression analyses, and reported as odds ratios (ORs) with 95% confidence intervals.
  
  
  RESULTS
  The OR for OTCA use was 1.42 (0.94-2.14) (statistically nonsignificant) among participants with low SEP but no perceived stress (reference high SEP, no perceived stress), 2.09 (1.53-2.85) for participants with perceived stress and high SEP, and 2.65 (1.66-4.25) among participants with perceived stress and low SEP. In analysis, stratified by SOC associations were stronger among participants with low SOC than among those with high SOC.
  
  
  CONCLUSIONS
  Individuals exposed to both low SEP and high perceived stress have high odds for using OTCA for headache, apparently higher than participants only exposed to 1 of these factors. SOC may act as a buffer against the harmful effects of perceived stress and low SEP on OTCA use. Health care professionals and policymakers need to be aware of the sensitivity of OTCA use to psychosocial and social circumstances.
authors.affiliation: National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark. vibe@niph.dk
authors.forename: Vibeke
authors.initials: V
authors.lastname: Koushede
authors.forename: Ebba Holme
authors.initials: EH
authors.lastname: Hansen
authors.forename: Anette
authors.initials: A
authors.lastname: Andersen
authors.forename: Bjørn E
authors.initials: BE
authors.lastname: Holstein
mesh_terms: D000328:Adult; D000367:Age Factors; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006261:Headache / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D015438:Health Behavior; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D004366:Nonprescription Drugs / Q000009:adverse effects / Q000627:therapeutic use*; D016017:Odds Ratio; D010465:Perception; D015995:Prevalence; D060685:Sense of Coherence; D012923:Social Class; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology*
chemical_list: D000700:Analgesics; D004366:Nonprescription Drugs