Table 3.
Associations with escalation in pharmacological pain treatment for the Starter group of chronic analgesic treatment
| Exposure | Adjusted OR | 95% CI |
|
| Lower | Upper | ||
| Analgesics* | |||
| Level 1 | 58.23 | 53.60 | 63.27 |
| Level 2 | 17.92 | 16.75 | 19.16 |
| Level 3 | 4.66 | 4.23 | 5.14 |
| Level 4 | 1.36 | 1.27 | 1.45 |
| Level 5 | Reference | – | – |
| Gender | |||
| Female | 0.97 | 0.95 | 0.99 |
| Male | Reference | 0.00 | 0.00 |
| Age (years) | |||
| 15–25 | 0.73 | 0.69 | 0.77 |
| 26–40 | 0.81 | 0.78 | 0.84 |
| 41–65 | 0.87 | 0.85 | 0.90 |
| 66–85 | Reference | – | – |
| Urbanisation† | |||
| 1 | 1.24 | 1.18 | 1.30 |
| 2 | 1.16 | 1.11 | 1.22 |
| 3 | 1.11 | 1.06 | 1.17 |
| 4 | 1.07 | 1.02 | 1.13 |
| 5 | Reference | – | – |
| Deprived neighbourhood | |||
| Yes | 1.07 | 1.02 | 1.11 |
| No | Reference | – | – |
| SNRI | |||
| Before start of analgesics‡ | 1.05 | 0.96 | 1.14 |
| Same start date | 1.28 | 0.97 | 1.69 |
| After analgesics started | 1.26 | 1.09 | 1.45 |
| None | Reference | – | – |
| SSRI | |||
| Before start of analgesics | 0.97 | 0.92 | 1.02 |
| Same start date | 0.97 | 0.83 | 1.15 |
| After analgesics started | 1.07 | 0.97 | 1.18 |
| None | Reference | – | – |
| TCA | |||
| Before start of analgesics | 1.23 | 1.15 | 1.32 |
| Same start date | 1.32 | 1.12 | 1.54 |
| After analgesics started | 2.19 | 2.03 | 2.36 |
| None | Reference | – | – |
| Other antidepressants | |||
| Before start of analgesics | 1.03 | 0.93 | 1.15 |
| Same start date | 0.93 | 0.71 | 1.21 |
| After analgesics started | 1.22 | 1.06 | 1.42 |
| None | Reference | – | – |
| Antipsychotics | |||
| Before start of analgesics | 0.92 | 0.85 | 1.01 |
| Same start date | 0.69 | 0.58 | 0.83 |
| After analgesics started | 2.42 | 2.18 | 2.67 |
| None | Reference | – | – |
| Mood stabilisers | |||
| Before start of analgesics | 1.40 | 1.10 | 1.79 |
| Same start date | 0.91 | 0.43 | 1.89 |
| After analgesics started | 0.71 | 0.39 | 1.31 |
| None | Reference | – | – |
| Sedatives | |||
| Before start of analgesics | 1.24 | 1.20 | 1.28 |
| Same start date | 1.25 | 1.18 | 1.33 |
| After analgesics started | 1.82 | 1.74 | 1.89 |
| None | Reference | – | – |
| Cardiovascular drugs | |||
| Before start of analgesics | 1.16 | 1.13 | 1.19 |
| Same start date | 0.86 | 0.79 | 0.95 |
| After analgesics started | 1.35 | 1.26 | 1.45 |
| None | Reference | – | – |
| Other somatic drugs | |||
| Before start of analgesics | 1.25 | 1.22 | 1.29 |
| Same start date | 1.11 | 1.07 | 1.15 |
| After analgesics started | 1.19 | 1.15 | 1.23 |
| None | Reference | – | – |
| Migraine medication | |||
| Before start of analgesics | 0.83 | 0.77 | 0.89 |
| Same start date | 0.95 | 0.78 | 1.17 |
| After analgesics started | 0.91 | 0.81 | 1.02 |
| None | Reference | – | – |
*
Escalation = change to a higher level of analgesic potency, level 5= highest level.
†
1= highest level of urbanisation, 5= rural environment.
‡
Starting date of medication (before, at the same day or after start of analgesics).
TCA, tricyclic antidepressants; SNRI, selective noradrenaline–serotonin reuptake inhibitors; SSRI, selective serotonin reuptake inhibitors.