title: The impact of socioeconomic and clinical factors on purchase of prescribed analgesics before and after hysterectomy on benign indication.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors: *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.
authors: Signe B
authors: SB
authors: Daugbjerg
authors: Birgitte
authors: B
authors: Brandsborg
authors: Bent
authors: B
authors: Ottesen
authors: Finn
authors: F
authors: Diderichsen
authors: Merete
authors: M
authors: Osler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use*; D003718:Denmark / Q000453:epidemiology; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D017723:Drug Utilization Review; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology* / Q000517:prevention & control*; D057240:Patient Preference / Q000706:statistics & numerical data*; D011292:Premedication / Q000706:statistics & numerical data*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D016387:Women's Health / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D000700:Analgesics