title: Prevalence, trends, patterns and associations of analgesic use in Germany.
abstract: BACKGROUND
  Despite the public health relevance of analgesic use, large-scale studies on this topic in Germany are lacking. This study describes the prevalence, trends, associations and patterns of use of prescription and over-the-counter (OTC) analgesics, focusing on five of the most common agents: aspirin, diclofenac, ibuprofen, naproxen and paracetamol.
  
  
  METHODS
  Data from two representative population-based surveys: The German National Health Interview and Examination Survey 1998 (GNHIES98 n = 7099) and the German Health Interview and Examination Survey for Adults 2008-2011 (DEGS1 n = 7091) was investigated. Information on all medicines consumed in the previous 7 days was collected via computer-assisted personal interviews with adults aged 18-79 years. Associations between analgesic use and socio-demographic and health-behaviour factors were analysed using logistic regression models.
  
  
  RESULTS
  Analgesic use has increased over the last decade from 19 to 21%. This was exclusively due to the rise in OTC analgesic use from 10.0 to 12.2%. Prescribed analgesic use remained constant (7.9%). Findings from DEGS1 indicate that ibuprofen is the most commonly used analgesic followed by aspirin and paracetamol. OTC analgesic use is higher among women and smokers, but lower among older adults (65-79 years). Prescribed analgesics use is higher among women, older adults, smokers and obese adults with medium or high socio- economic status. Adults performing more than 2 h/week of physical exercise use fewer analgesics.
  
  
  CONCLUSIONS
  Among the adult population of Germany, the prevalence of OTC analgesic use has significantly increased over the last decade. We found differences between adults consuming OTC and prescribed analgesics (or both) concerning their health behaviour and health conditions. International direct comparison between prevalence rates of analgesic use was limited due to varying availability of analgesics between countries and to methodological differences.
  
  
  CONCLUSIONS
  About one in five community dwelling adults aged 18-79 years in Germany use analgesics in a given week. Considering the potential harms of analgesic use, monitoring of prevalence, patterns and determinants of use at the population level are important steps to inform disease prevention and health promotion policies.
authors.affiliation: Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 64, 12101, Berlin, Germany. sarganas-margolisg@rki.de.
authors.forename: Giselle
authors.initials: G
authors.lastname: Sarganas
authors.affiliation: Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 64, 12101, Berlin, Germany. buttery.amanda@gmail.com.
authors.forename: Amanda K
authors.initials: AK
authors.lastname: Buttery
authors.affiliation: Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 64, 12101, Berlin, Germany. zhuangw@rki.de.
authors.forename: Wanli
authors.initials: W
authors.lastname: Zhuang
authors.affiliation: Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 64, 12101, Berlin, Germany. wolfi@rki.de.
authors.forename: Ingrid-Katharina
authors.initials: IK
authors.lastname: Wolf
authors.affiliation: Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 64, 12101, Berlin, Germany. gramsd@rki.de.
authors.forename: Daniel
authors.initials: D
authors.lastname: Grams
authors.affiliation: Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 64, 12101, Berlin, Germany. Schaffrath-rosarioa@rki.de.
authors.forename: Angelika Schaffrath
authors.initials: AS
authors.lastname: Rosario
authors.affiliation: Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 64, 12101, Berlin, Germany. scheidt-navec@rki.de.
authors.forename: Christa
authors.initials: C
authors.lastname: Scheidt-Nave
authors.affiliation: Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 64, 12101, Berlin, Germany. knopfh@rki.de.
authors.forename: Hildtraud
authors.initials: H
authors.lastname: Knopf
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use; D004008:Diclofenac / Q000627:therapeutic use; D004358:Drug Therapy / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D005858:Germany / Q000453:epidemiology; D006306:Health Surveys / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009288:Naproxen / Q000627:therapeutic use; D004366:Nonprescription Drugs / Q000627:therapeutic use*; D010146:Pain / Q000453:epidemiology / Q000517:prevention & control*; D015995:Prevalence; D012737:Sex Factors; D012923:Social Class; D055815:Young Adult
chemical_list: D000700:Analgesics; D004366:Nonprescription Drugs; D004008:Diclofenac; D000082:Acetaminophen; D009288:Naproxen; D001241:Aspirin; D007052:Ibuprofen