Baseline characteristics of the patient population with chronic analgesic treatment
Starter group | Continuation group | |||||||
Deprived | Urbanicity* | Urbanicity | Non-deprived | Deprived | Urbanicity | Urbanicity | Non-deprived | |
Neighbourhoods | 1 | 2–5 | Neighbourhoods | Neighbourhoods | 1 | 2–5 | Neighbourhoods | |
Patients (absolute) | 12 485 | 45 458 | 120 916 | 153 889 | 21 799 | 78 358 | 204 678 | 261 237 |
Change in analgesics† | ||||||||
De-escalation | 13.3 | 12.1 | 10.4 | 10.7 | 13.2 | 12.5 | 11.2 | 11.4 |
Neutral | 70.1 | 71.6 | 74.5 | 74.0 | 70.0 | 71.4 | 73.7 | 73.3 |
Escalation | 16.5 | 16.3 | 15.1 | 15.3 | 16.8 | 16.1 | 15.1 | 15.3 |
Gender | ||||||||
Male | 39.8 | 39.3 | 40.3 | 40.0 | 36.7 | 35.2 | 34.6 | 34.6 |
Female | 60.2 | 60.7 | 59.7 | 60.0 | 63.3 | 64.8 | 65.4 | 65.4 |
Age (years) | ||||||||
15–25 | 6.3 | 6.1 | 6.5 | 6.4 | 1.8 | 1.6 | 1.8 | 1.7 |
26–40 | 23.8 | 19.2 | 16.3 | 16.6 | 14.0 | 10.8 | 9.7 | 9.7 |
41–65 | 50.0 | 49.6 | 50.9 | 50.6 | 56.9 | 53.4 | 51.8 | 51.9 |
65–85 | 19.8 | 25.2 | 26.2 | 26.4 | 27.3 | 34.2 | 36.7 | 36.7 |
First analgesics | ||||||||
Level 1 | 3.2 | 3.9 | 4.0 | 4.0 | 3.0 | 3.8 | 4.1 | 4.1 |
Level 2 | 64.8 | 66.6 | 72.6 | 71.4 | 47.8 | 47.1 | 53.6 | 52.1 |
Level 3 | 2.2 | 2.5 | 2.6 | 2.6 | 6.4 | 8.1 | 8.9 | 8.8 |
Level 4 | 27.4 | 24.2 | 18.3 | 19.3 | 36.1 | 33.9 | 27.6 | 28.8 |
Level 5 | 2.4 | 2.9 | 2.6 | 2.7 | 6.8 | 7.2 | 5.9 | 6.2 |
Level 4/5 | 29.8 | 27.0 | 20.8 | 21.9 | 42.8 | 41.1 | 33.5 | 35.0 |
Last analgesics | ||||||||
Level 1 | 3.4 | 3.9 | 4.0 | 4.0 | 3.4 | 4.1 | 4.3 | 4.3 |
Level 2 | 61.9 | 63.0 | 68.4 | 67.4 | 44.5 | 44.1 | 50.1 | 48.8 |
Level 3 | 3.0 | 3.3 | 3.4 | 3.4 | 7.0 | 8.4 | 9.2 | 9.1 |
Level 4 | 27.6 | 24.6 | 18.9 | 19.9 | 36.8 | 34.5 | 28.4 | 29.6 |
Level 5 | 4.1 | 5.2 | 5.3 | 5.3 | 8.3 | 9.0 | 7.9 | 8.2 |
Level 4/5 | 31.7 | 29.8 | 24.2 | 25.2 | 45.1 | 43.4 | 36.3 | 37.7 |
Concomitant medication‡ | ||||||||
Any concomitant medication | 78.8 | 79.0 | 77.3 | 77.7 | 89.3 | 89.6 | 88.0 | 88.4 |
Migraine medication | 3.9 | 3.6 | 3.8 | 3.7 | 5.9 | 5.2 | 5.1 | 5.1 |
Any psychotropic medication | 35.1 | 36.6 | 34.8 | 35.3 | 51.6 | 53.2 | 50.2 | 51.0 |
Sedatives | 27.0 | 29.0 | 27.4 | 27.9 | 41.5 | 43.4 | 40.6 | 41.4 |
Mood stabilisers | 0.2 | 0.3 | 0.2 | 0.3 | 0.3 | 0.4 | 0.4 | 0.4 |
Antipsychotics total | 4.1 | 3.9 | 3.1 | 3.2 | 6.7 | 6.1 | 4.9 | 5.1 |
Antipsychotics 2nd generation | 2.4 | 2.2 | 1.5 | 1.6 | 4.1 | 3.5 | 2.5 | 2.7 |
Antipsychotics classic | 2.0 | 2.1 | 1.8 | 1.8 | 3.2 | 3.2 | 2.7 | 2.8 |
Bupropion | 0.1 | 0.1 | 0.1 | 0.1 | 0.2 | 0.2 | 0.1 | 0.1 |
MAO inhibitors | 0.0 | 0.0 | 0.1 | 0.0 | 0.1 | 0.1 | 0.1 | 0.1 |
TCA | 5.2 | 5.0 | 5.0 | 5.0 | 9.5 | 9.4 | 9.6 | 9.6 |
Other antidepressants§ | 2.4 | 2.0 | 1.6 | 1.7 | 4.0 | 3.3 | 2.7 | 2.8 |
SNRI | 2.6 | 2.4 | 2.2 | 2.2 | 4.5 | 4.0 | 3.5 | 3.6 |
SSRI | 7.5 | 7.0 | 6.4 | 6.5 | 10.3 | 10.0 | 9.0 | 9.2 |
Psychostimulants | 0.4 | 0.5 | 0.5 | 0.5 | 0.3 | 0.5 | 0.4 | 0.5 |
Any somatic medication | 72.3 | 72.6 | 71.0 | 71.4 | 83.0 | 82.9 | 81.7 | 81.9 |
Cardiovascular medication¶ | 30.9 | 31.4 | 30.8 | 30.9 | 35.2 | 34.9 | 34.9 | 34.9 |
Other Somatic medication** | 65.2 | 65.5 | 64.0 | 64.3 | 76.9 | 76.7 | 75.4 | 75.6 |
Patient characteristics are presented as percentages (eg, age, gender, level of analgesic treatment, change in analgesic treatment (eg, escalation, de-escalation and neutral development of prescriptions) and concomitant medication). Absolute patient numbers are presented for the Starter and the Continuation groups of chronic analgesic treatment concerning level of urbanicity and for neighbourhood deprivation.
↵* Urbanicity = urbanisation (level 1= highest level of urbanisation; level 5= rural environment).
↵† Change in pain medication from the first to the last prescription (neutral = no change in level of potency, escalation = change to a higher level of analgesic potency, de-escalation = change to a lower level of analgesic potency).
↵‡ Concomitant drug use, observed during a period of 12 months.
↵§ Other than bupropion, MAO inhibitors, SNRI, SSRI and TCA.
↵¶ Cardiovascular medication: β-blocker, calcium antagonist, ACE inhibitor, angiotensin II inhibitor.
↵** Gastrointestinal medication: antidiabetics, steroid antiphlogistics, respiratory medication.
TCA, tricyclic antidepressants; SNRI, selective noradrenaline–serotonin reuptake inhibitors; SSRI, selective serotonin reuptake inhibitors.