Non-medical Use of Prescription Gabapentinoids (Gabapentin and Pregabalin) in Five European Countries

Background: Non-medical use (NMU) of prescription GABA analogs (pregabalin and gabapentin) has been reported especially in opiate dependent persons. However, by now the prevalence of NMU of gabapentinoids in the general population has not been sufficiently evaluated. The aim of this research paper is to determine the prevalence of prescription GABA analog NMU and associated demographics in five European countries with special detail of Spain.Methods: The RADARS Survey of Non-Medical Use of Prescription Drugs Program (NMURx) is a harmonized series of contemporaneous cross-sectional surveys of adults conducted in multiple countries. NMURx collects data from the general population in each participating country about NMU of prescription drugs, illicit drugs, and associated demographics. NMU was defined as “using a medication without a doctor's prescription or for any reason other than what was recommended by their doctor.” Responses from Spain (4Q2017, n=10,062) were analyzed in detail. Comparative data were available from France, Germany, Italy, and UK. Responses were collected using non-probability quota sampling and post-stratification population weighting was applied to reflect the national distributions of adults, based on age, gender, and census region. Rates of NMU and associated demographics were reported as rate of past 90-day NMU per 100,000 adult population with 95% confidence intervals.Results: Germany (1,197 per 100,000 adult population [95% CI: 1,004.3–1,379.1]) and United Kingdom (1,067 per 100,000 adult population [95% CI: 851.3–1,283.2]) presented the highest prevalence of gabapentinoids NMU. In Spain the prevalence of past 90 days GABA analog NMU was: 344.4, 95% (CI 204.8–484.0), with male predominance. Those who non-medically use GABA analogs had a higher prevalence of lifetime chronic pain, lifetime illicit drug use, and previous substance abuse treatment. In Spain, 20% of respondents who ever have used gabapentinoids, reported a lifetime NMU; the prevalence was higher for pregabalin 624 (6.2%) than for gabapentin 444 (4.4%). The main reasons for use were to self-treat pain and other medical conditions.Conclusions: The risk of NMU of gabapentinoids should not be neglected. Subjects with a history of chronic pain and lifetime substance use disorders had an increased risk of NMU of gabapentinoids.

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Alcohol and other drug use among Belgian workers and job-related consequences

Occupational and Environmental Medicine ◽

10.1136/oemed-2019-105690 ◽

2019 ◽

Vol 76 (9) ◽

pp. 652-659 ◽

Cited By ~ 2

Author(s):

Marie-Claire Lambrechts ◽

Lieve Vandersmissen ◽

Lode Godderis

Keyword(s):

Prescription Drugs ◽

Illicit Drugs ◽

Problem Drinking ◽

Well Being ◽

Cross Sectional Study ◽

Cross Sectional ◽

Prevalence Data ◽

Increased Risk ◽

Psychoactive Medication ◽

Alcohol And Other Drugs

ObjectivesThis study aimed to obtain prevalence data on use of alcohol and other drugs (AOD) among Belgian workers, and to explore the associations between self-reported AOD use and job-related effects as experienced by workers, and the level of workers’ well-being, respectively.MethodsIn this cross-sectional study (2016), 5367 workers filled out a questionnaire including validated instruments such as the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C). Job-related effects were defined as: being late at work, absenteeism, loss of productivity, injuries, conflicts with co-workers and sanctions by employers. Descriptive and multiple logistic regression analyses were performed.ResultsBased on AUDIT-C, 39.1% of last year drinkers had an indication of problem drinking. The odds of experienced job-related effects was 3.6 (CI 2.86 to 4.60) times larger than the odds among workers without this indication. This ratio decreased to 3.2 (CI 2.52 to 4.11), controlling for language, gender, family context, level of education and sector. Respondents who used illicit drugs more frequently (>once a month) also had an increased risk for experienced job-related effects (OR 5.8; CI 2.87 to 11.84). Having a low level of well-being increased the risk for job-related effects due to psychoactive medication (OR 2.3, CI 1.10 to 4.91).DiscussionIn this study, self-reported AOD use was associated with short-term job-related effects. This suggests that an AOD policy in different sectors is needed with respect for the organisational culture. Its focus should lie on prevention and early detection of AOD problems, and on the mental health of workers. Attention is required for the non-medical use of prescription drugs.

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Prescribing Trends of Anticholinergic Drugs Between 1989 and 2017: A UK Biobank Study

Innovation in Aging ◽

10.1093/geroni/igaa057.675 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 209-209

Author(s):

Jure Mur ◽

Simon Cox ◽

Riccardo Marioni ◽

Tom Russ ◽

Graciela Muniz Terrera

Keyword(s):

Prescription Drugs ◽

Anticholinergic Drug ◽

Later Life ◽

Anticholinergic Drugs ◽

Uk Biobank ◽

Linear Estimate ◽

Cross Sectional ◽

Increased Risk ◽

Prescribing Trends ◽

Anticholinergic Burden

Abstract Prescription drugs with anticholinergic properties are commonly prescribed and negatively impact physical performance, cognitive function, and increase the risk of falls and dementia. The prevalence of anticholinergic drugs is high in later life, when there is an increased risk of adverse drug effects. Recent, in-depth longitudinal analyses of specifically anticholinergic prescribing in Europe is lacking. Prescriptions for the UK-Biobank participants (n=222,122) were ascertained from primary care electronic patient records. We assigned anticholinergic activity to each drug by using a composite score. We used linear regression to study the association between current anticholinergic burden and time period, explore secular trends in anticholinergic use, and various demographic factors. We further explored the results in the context of different classes of prescriptions drugs. 74 distinct drugs in the sample (1.1%) had anticholinergic effects. An individual’s overall anticholinergic burden increased nonlinearly (linear estimate=0.474, quadratic estimate = 0.094, both p<2.2x10-16) between 1989 (mean=0.09, σ=0.009) and 2000 (mean=0.22, σ=0.006) and increased nonlinearly (linear estimate=0.282, quadratic estimate=0.074, both p<2.2x10-16) from 2000 to 2016 (mean=0.27, σ=0.009). The proportion of patients prescribed at least one anticholinergic drug per month increased from 6.1% to 16.7% from 1989 to 2000 and increased to 18.6% by 2016. When adjusted for sex and polypharmacy, age was negatively associated with recent cross-sectional anticholinergic burden (estimate=-0.042, p<2.2x10-16). Our results demonstrate an increase in prescribing of anticholinergic drugs over the past 30 years and indicate contemporary deprescribing of anticholinergic drugs in the later decades of life.

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Distribution of health anxiety in a general adult population and associations with demographic and social network characteristics

Psychological Medicine ◽

10.1017/s0033291720004122 ◽

2020 ◽

pp. 1-8

Author(s):

Anja Davis Norbye ◽

Birgit Abelsen ◽

Olav Helge Førde ◽

Unni Ringberg

Keyword(s):

Exponential Distribution ◽

Sex Education ◽

Household Income ◽

Adult Population ◽

Health Anxiety ◽

Care Utilization ◽

Cross Sectional ◽

Increased Risk ◽

General Adult Population

Abstract Background Health anxiety (HA) is associated with increased risk of disability, increased health care utilization and reduced quality of life. However, there is no consensus on which factors are important for the level of HA. The aim of this study was to explore the distribution of HA in a general adult population and to investigate whether demographic and social factors were associated with HA. Methods This study used cross-sectional data from the seventh Tromsø study. A total of 18 064 participants aged 40 years or older were included in the analysis. The six-item Whiteley Index (WI-6) with a 5-point Likert scale was used to measure HA. Sociodemographic factors included age, sex, education, household income, quality of friendship and participation in an organized activity. Results HA showed an exponential distribution among the participants with a median score of 2 points out of 24 points. In total, 75% had a total score of 5 points or less, whereas 1% had a score >14 points. Education, household income, quality of friendship and participation in organized activity were significantly associated with HA. The variable quality of friendship demonstrated the strongest association with HA. Conclusion Our study showed an exponential distribution of HA in a general adult population. There was no evident cut-off point to distinguish participants with severe HA based on their WI-6 score, indicating the importance of analysing HA as a complex, continuous construct. HA demonstrated strong associations with quality of friendship and participation in an organized activity.

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Left ventricular mechanical dispersion in a general population: Data from the Akershus Cardiac Examination 1950 study

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez210 ◽

2019 ◽

Author(s):

Erika N Aagaard ◽

Brede Kvisvik ◽

Mohammad O Pervez ◽

Magnus N Lyngbakken ◽

Trygve Berge ◽

...

Keyword(s):

General Population ◽

Global Longitudinal Strain ◽

Population Data ◽

Left Ventricular ◽

Linear Regression Models ◽

Cross Sectional ◽

Clinical Model ◽

Mechanical Dispersion ◽

Obesity And Diabetes ◽

Increased Risk

Abstract Aims Increased left ventricular mechanical dispersion by 2D speckle tracking echocardiography predicts ventricular arrhythmias in ischaemic heart disease and heart failure. However, little is known about mechanical dispersion in the general population. We aimed to study mechanical dispersion in the general population and in diseases associated with increased risk of cardiovascular disease. Methods and results The present cross-sectional study consists of 2529 subjects born in 1950 included in the Akershus Cardiac Examination (ACE) 1950 study. Global longitudinal strain (GLS) was assessed from 17 strain segments, and mechanical dispersion calculated as the standard deviation of contraction duration of all segments. The cohort was divided according to the median value of mechanical dispersion, and multivariable linear regression models were performed with mechanical dispersion as the dependent variable. The prevalence of coronary artery disease (CAD), hypertension, obesity, and diabetes (P < 0.01 for all) was significantly higher in subjects with supra-median mechanical dispersion. In a multivariable clinical model, CAD (B = 7.05), hypertension (B = 4.15; both P < 0.001), diabetes (B = 3.39), and obesity (B = 1.89; both P < 0.05) were independently associated with increasing mechanical dispersion. When echocardiographic indices were added to the multivariable model, CAD (B = 4.38; P < 0.01) and hypertension (B = 2.86; P < 0.001) remained significant in addition to peak early diastolic tissue velocity e’ (B = −2.00), GLS (B = 1.68), and ejection fraction (B = 0.22; P < 0.001 for all). Conclusion In a general middle-aged population, prevalent CAD and hypertension were associated with increasing mechanical dispersion, possibly indicating elevated risk of fatal arrhythmias and sudden cardiac death. Albeit weaker, systolic and diastolic dysfunction, were also associated with increasing mechanical dispersion.

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TSH Levels as an Independent Risk Factor for NAFLD and Liver Fibrosis in the General Population

Journal of Clinical Medicine ◽

10.3390/jcm10132907 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2907

Author(s):

Alba Martínez-Escudé ◽

Guillem Pera ◽

Anna Costa-Garrido ◽

Lluís Rodríguez ◽

Ingrid Arteaga ◽

...

Keyword(s):

Risk Factor ◽

Liver Fibrosis ◽

General Population ◽

Transient Elastography ◽

Atherogenic Dyslipidemia ◽

Control Group ◽

Cross Sectional ◽

Alcoholic Fatty Liver ◽

Increased Risk ◽

Tsh Levels

Thyroid hormones may be a risk factor for the development of non-alcoholic fatty liver disease (NAFLD) and its progression to liver fibrosis. The aim of this study is to investigate the relationship between thyroid stimulating hormone (TSH) levels, NAFLD, and liver fibrosis in the general population. A descriptive cross-sectional study was performed in subjects aged 18–75 years randomly selected from primary care centers between 2012 and 2016. Each subject underwent clinical evaluation, physical examination, blood tests and transient elastography. Descriptive and multivariate logistic regression analyses were used to identify factors associated with NAFLD and fibrosis. We included 2452 subjects (54 ± 12 years; 61% female). Subjects with TSH ≥ 2.5 μIU/mL were significantly associated with obesity, atherogenic dyslipidemia, metabolic syndrome (MetS), hypertransaminasemia and altered cholesterol and triglycerides. The prevalence of NAFLD and liver fibrosis was significantly higher in subjects with TSH ≥ 2.5 (μIU/mL). We found a 1.5 times increased risk of NAFLD, 1.8 and 2.3 times increased risk of liver fibrosis for cut-off points of ≥ 8.0 kPa and ≥ 9.2 kPa, respectively, in subjects with TSH ≥ 2.5 μIU/mL compared with TSH < 2.5 μIU/mL (control group), independent of the presence of MetS. These findings remained significant when stratifying TSH, with values ≥ 10 μIU/mL.

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Cardiovascular risk factors associated with the metabolic syndrome are more prevalent in people reporting chronic pain: Results from a cross-sectional general population study

Pain ◽

10.1016/j.pain.2013.04.043 ◽

2013 ◽

Vol 154 (9) ◽

pp. 1595-1602 ◽

Cited By ~ 35

Author(s):

Nicola J. Goodson ◽

Blair H. Smith ◽

Lynne J. Hocking ◽

Mark M. McGilchrist ◽

Anna F. Dominiczak ◽

...

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Chronic Pain ◽

Cardiovascular Risk ◽

General Population ◽

Cardiovascular Risk Factors ◽

Cross Sectional ◽

General Population Study ◽

Factors Associated ◽

The Metabolic Syndrome

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Prevalence and Characteristics of Chronic Pain in Buprenorphine and Methadone-Maintained Patients

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.641430 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jessica Delorme ◽

Lucie Pennel ◽

Georges Brousse ◽

Jean-Pierre Daulouède ◽

Jean-Michel Delile ◽

...

Keyword(s):

Chronic Pain ◽

Illicit Drugs ◽

Opioid Analgesics ◽

Cross Sectional Study ◽

Opioid Agonist ◽

Cross Sectional ◽

Number Of Patients ◽

Chronic Pain Patients ◽

Associated Risk Factors ◽

Pain Patients

Chronic pain and substance use disorders frequently co-occur. Indeed, chronic pain is highly prevalent, affecting 23–68% of patients receiving opioid agonist treatments (OAT) worldwide. The majority of available estimates come from American studies, but data are still lacking in Europe. We aim to provide European estimates of the prevalence of chronic pain in patients receiving OAT using French data, since France is the first European country in terms of number of patients with OAT. The secondary objectives were to characterize the features and management of chronic pain, as well identify associated risk factors. We conducted a multicenter, cross-sectional study, recruiting patients treated either with buprenorphine or methadone in 19 French addiction centers, from May to July 2016. All participants had to complete a semi-directed questionnaire that collected sociodemographic and medical data, pain characteristics, and licit or illicit drug consumption. In total, 509 patients were included. The prevalence of chronic pain was estimated at 33.2% (95% CI: 29.1–37.3). Compared to non-chronic pain patients, chronic pain patients were older (38.4 vs. 36.1 years, p = 0.006), were more unemployed (66 vs. 52%, p = 0.003), had more psychiatric comorbidities (50 vs. 39%, p = 0.02), and split their OAT for pain management more frequently (24 vs. 7%, p = 0.009). Pain intensity was moderate or severe in 75% of chronic pain patients. Among patients with chronic pain, 15.4% were not prescribed, and did not self-medicate with, any analgesic drugs, 52.1% were prescribed analgesics (non-opioid analgesics, 76.3%; codeine, tramadol, opium, 27.2%; and morphine, fentanyl, oxycodone, 11.8%), and 32.5% exclusively self-medicated with analgesics. Moreover, 20.1% of patients with chronic pain also used illicit drugs for pain relief. On multivariate analysis, variables that remained significantly associated with chronic pain were age [OR = 1.03 (95% CI: 1.00–1.05], p = 0.02], anxiety [OR = 1.52 (1.15–2.02), p = 0.003], and depression [OR = 1.25 (1.00–1.55), p = 0.05]. Chronic pain is a highly prevalent condition in patients receiving OAT, and its appropriate management remains uncertain, since insufficient relief and frequent additional self-medications with analgesics or illicit drugs were reported by these patients. Increased awareness among caregivers is urgently needed regarding a systematic and careful assessment, along with an adequate management of chronic pain in patients receiving OAT.

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Robust association between autistic traits and psychotic-like experiences in the adult general population: epidemiological study from the 2007 Adult Psychiatric Morbidity Survey and replication with the 2014 APMS

Psychological Medicine ◽

10.1017/s0033291720001373 ◽

2020 ◽

pp. 1-7

Author(s):

Anton P. Martinez ◽

Sophie Wickham ◽

Georgina Rowse ◽

Elizabeth Milne ◽

Richard P. Bentall

Keyword(s):

General Population ◽

Psychiatric Morbidity ◽

Autistic Traits ◽

Cross Sectional ◽

Increased Risk ◽

Dependent Variables ◽

Independent Variable ◽

Logistic Regressions ◽

Specific Symptoms ◽

First Time

Abstract Background Studies have shown that there are overlapping traits and symptoms between autism and psychosis but no study to date has addressed this association from an epidemiological approach in the adult general population. Furthermore, it is not clear whether autistic traits are associated with specific symptoms of psychosis or with psychosis in general. We assess these associations for the first time by using the Adult Psychiatric Morbidity Survey (APMS) 2007 and the APMS 2014, predicting an association between autistic traits and probable psychosis, and specific associations between autistic traits and paranoia and strange experiences. Methods Participants (N = 7353 in 2007 and 7500 in 2014) completed the Psychosis Screening Questionnaire (PSQ) and a 20-item version of the Autism Quotient (AQ-20). Binomial logistic regressions were performed using AQ-20 as the independent variable and probable psychosis and specific symptoms as dependent variables. Results In the APMS 2007 dataset, significant associations were found between autism traits and probable psychosis, paranoia, thought insertion, and strange experiences. These results were replicated in APMS 2014 but with the additional significant association between autistic traits and hallucinations. Participants in the highest quartile of the AQ-20, compared with the lowest quartile, had an increased risk of probable psychosis of odds ratio (OR) = 15.5 [95% confidence interval (CI) 4.57–52.6] in APMS 2007 and OR = 22.5 (95% CI 7.64–66.3) in APMS 2014. Conclusions Autistic traits are strongly associated with probable psychosis and psychotic experiences with the exception of mania. Limitations such as the cross-sectional nature of the study are discussed.

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