The Impact of Socioeconomic and Clinical Factors on Purchase of Prescribed Analgesics Before and After Hysterectomy on Benign Indication

OBJECTIVE: Pelvic pain is a primary symptom of women referred for hysterectomy. This study identified risk factors for purchase of prescribed analgesics before and after hysterectomy and examined purchase changes after hysterectomy, specifically focusing on socioeconomic effects. METHODS: Nearly all Danish women (n=13,420) with a hysterectomy on benign indication between 2004 and 2006 were included in a registry-based follow-up study. Information on prescription analgesic purchase was from the Danish National Prescription Registry. Factors associated with a purchase and associations between socioeconomic factors and changes in analgesic purchase were assessed. RESULTS: Analgesic purchase after hysterectomy was independently predicted by age below 35 or above 65 years, body mass index >29.9, high American Society of Anesthesiologists (ASA) score, uterus weight <300 g, comorbidity, and less than high school education. In this study, 15% of women initiated or increased analgesic purchase after hysterectomy, whereas 50% with a purchase before hysterectomy ceased buying afterward. Women with low socioeconomic status (SES) (assessed by education, employment, and income) were more likely to increase purchase of analgesics than women with high SES (odds ratio for less than high school vs. more than high school=1.58; 95% confidence interval, 1.31-1.91) and less likely to cease use than women with high SES (odds ratio=0.67; confidence interval, 0.52-0.86 for low vs. high education). DISCUSSION: These results suggest that purchase of analgesics after hysterectomy is related to preoperative factors. Compared with women with high SES, women with low SES had less favorable changes in analgesic purchase after hysterectomy.