title: Use of analgesics in young adults as a predictor of health care utilization and pain prevalence: Israel defense forces experience.
abstract: Pain evaluation in large community studies is difficult. Analgesics can be a useful tool in estimating pain-related conditions in which analgesic use is highly regulated. In this study, we evaluated analgesics consumption patterns of regular Israel Defense Force soldiers. We have performed a historical cohort study of 665,137 young adults during active duty in 2002 to 2012. Analgesics were prescribed to 518,242 (78%) soldiers, mostly for musculoskeletal pain (69.3%), abdominal pain (12.7%), and headache (12.1%). Acute (1-14 days), subacute (15-90), and chronic (>90 days) analgesic use episodes were experienced by 396,987 (59.7%), 74,591 (11.2%), and 46,664 (7%) of the population. In a multivariate model, predictors for chronic analgesics use were as follows: low intelligence, service in a combat supporting unit, previous pain diagnosis, male sex, Israeli nativity, low socioeconomic status, and high body mass index. Low intelligence had the highest odds ratio for chronic analgesic consumption (2.1) compared with other predictors. Chronic analgesic use was associated with a significant increase in health care utilization cost per year (911$ per soldier vs 199$ for nonusers), increased sick leave days per year (7.09 vs 0.67 for nonusers), and higher dropout rate from combat units (25% vs 9.2% for nonusers). Chronic use of analgesics is common among young adults, and it is an important predictor for unsuccessful military service and high health care utilization costs. Further studies in other setups are indicated.
authors.affiliation: aIsrael Defense Force Medical Corps, Ramat Gan, Israel bDepartment of Management, Bar-Ilan University, Ramat Gan, Israel cDepartment of Neurology, Soroka University Medical Center, Ben Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Karina
authors.initials: K
authors.lastname: Dorfman
authors.forename: Olga
authors.initials: O
authors.lastname: Komargodski
authors.forename: Racheli
authors.initials: R
authors.lastname: Magnezi
authors.forename: Stanislav
authors.initials: S
authors.lastname: Lifshitz
authors.forename: Dorit
authors.initials: D
authors.lastname: Tzur
authors.forename: Nirit
authors.initials: N
authors.lastname: Yavnai
authors.forename: Gal
authors.initials: G
authors.lastname: Ifergane
mesh_terms: D000328:Adult; D000700:Analgesics / Q000191:economics* / Q000627:therapeutic use*; D017281:Cost of Illness; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008889:Military Personnel / Q000706:statistics & numerical data*; D010146:Pain / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D010147:Pain Measurement / Q000191:economics / Q000379:methods / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000700:Analgesics