title: Prescription trajectories and effect of total hip arthroplasty on the use of analgesics, hypnotics, antidepressants, and anxiolytics: results from a population of total hip arthroplasty patients.
abstract: Total hip arthroplasty (THA) has been shown to reduce pain and improve function. In addition, it is suggested that THA improves sleep and alleviates symptoms of anxiety and depression. Patients with chronic pain are frequent users of analgesic and psychotropic drugs and thereby risk adverse drug events. The impact of THA on such drug use has not been thoroughly investigated. Based on merged data from the Norwegian Prescription Database and the Norwegian Arthroplasty Register, this study sought to investigate redeemed medications in a complete population (N = 39,688) undergoing THA in 2005 to 2011. User rates and redeemed drug volume of analgesics (nonsteroid anti-inflammatory drugs (NSAIDs), opioids, and nonopioids) and psychotropics (hypnotics, anxiolytics, and antidepressants) were calculated for 4 quarters before and 4 quarters after surgery. We analysed preoperative prescription trends (Q1 vs Q4), postoperative prescription (Q4 vs Q5), and long-term effect of surgery (Q4 vs Q8). Before surgery, use of all drug groups increased from Q1 to Q4. Use of opioids, nonopioids, and hypnotics dramatically increased from Q4 to Q5. Long-term (Q4 vs Q8) surgery reduced prescriptions of analgesics, hypnotics, and anxiolytics, but not antidepressants. Overall, the present results extend the positive effects of THA to include reduced reliance on medication to alleviate symptoms.
authors.affiliation: Department of Clinical Psychology, University of Bergen, Bergen, Norway Department of Behavioural Sciences in Medicine, University of Oslo, Oslo, Norway Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway Sleep and Performance Research Center, College of Medical Sciences, Washington State University, Spokane, WA, USA Department of Clinical Medicine, University of Bergen, Bergen, Norway Department of Orthopaedics, Haukeland University Hospital, Bergen, Norway Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway Research Unit for General Practice, Uni Research Health, Bergen, Norway Kavli Research Center for Ageing and Dementia, Haraldsplass Hospital, Bergen, Norway Department of Clinical Science, University of Bergen, Bergen, Norway Diakonhjemmet Hospital, Oslo, Norway The Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway Department of Psychosocial Science, University of Bergen, Bergen, Norway.
authors.forename: Tone
authors.initials: T
authors.lastname: Blågestad
authors.forename: Inger H
authors.initials: IH
authors.lastname: Nordhus
authors.forename: Janne
authors.initials: J
authors.lastname: Grønli
authors.forename: Lars B
authors.initials: LB
authors.lastname: Engesæter
authors.forename: Sabine
authors.initials: S
authors.lastname: Ruths
authors.forename: Anette H
authors.initials: AH
authors.lastname: Ranhoff
authors.forename: Bjørn
authors.initials: B
authors.lastname: Bjorvatn
authors.forename: Ståle
authors.initials: S
authors.lastname: Pallesen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use*; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000639:trends*; D002648:Child; D059350:Chronic Pain / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery; D011307:Drug Prescriptions; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011446:Prospective Studies; D012042:Registries; D055815:Young Adult
chemical_list: D000700:Analgesics; D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D006993:Hypnotics and Sedatives