Abstract
Objective
Our objective was to describe patterns of medication use in a convenience sample of 309 women with a history of intimate partner violence (IPV) participating in a study of women’s health after leaving an abusive partner (WHES).
Methods
Using data collected through interviews and health assessments, frequencies of past-month use of medications; abuse experienced, health problems and medical diagnoses; and selected demographics were calculated. Associations among abuse history, employment status, health problems, diagnoses, and medications were explored. Comparisons of rates of medication use in women in the WHES and the Canadian Community Health Survey (CCHS) 2.1 were calculated.
Findings
Almost half of participants were taking pain and/or psychotropic medications, with almost one third taking antidepressants. Child abuse history, adult sexual assault history and unemployment were associated with taking psychotropic medications. Overall rates of medication use were similar to those of Canadian women of similar age in the CCHS 2.1. However, women in the WHES were more likely to be taking antidepressants, anxiolytics and inhalants, and less likely to be taking oral contraceptives, over-the counter (OTC) pain relievers, and OTC cough and cold medications.
Conclusion
The pattern of medication use in women who have experienced IPV differs from that in the general population. The complex associations found among health problems, employment, diagnoses, and medication use highlight the need to consider treatment patterns within the context of the impact of lifetime abuse, economic survival, and parenting demands. Medication use must be understood as only one of a range of health interventions available to assist abused women to promote their health.
MeSH terms: Domestic violence, spousal violence, prescription drugs, non-prescription drugs, therapeutics
Résumé
Objectif
Décrire les habitudes de consommation de médicaments au sein d’un échantillon de commodité de 309 femmes victimes de violence entre partenaires intimes (VPI) ayant participé à une enquête sur la santé des femmes (WHES) après avoir quitté un partenaire violent.
Méthode
À la faveur d’entretiens et d’évaluations de l’état de santé, nous avons déterminé la fréquence de consommation de médicaments au cours du mois antérieur, la violence subie, les problèmes de santé et les diagnostics médicaux, et établi certaines données démographiques. Les liens entre les antécédents de mauvais traitements, l’emploi, les problèmes de santé, les diagnostics et les médicaments ont été analysés. Nous avons ensuite comparé les taux de consommation de médicaments par les femmes de l’enquête WHES et de l’Enquête sur la santé dans les collectivités canadiennes (ESCC), cycle 2.1.
Résultats
Près de la moitié des participantes prenaient des analgésiques et/ou des médicaments psychotropes, et près du tiers prenaient des antidépressifs. Les antécédents de mauvais traitements durant l’enfance, d’agression sexuelle à l’âge adulte et de chômage étaient associés à la consommation de médicaments psychotropes. Dans l’ensemble, les taux de consommation de médicaments étaient semblables à ceux des Canadiennes du même âge recensées dans l’ESCC 2.1. Toutefois, les participantes de l’enquête WHES étaient plus susceptibles de prendre des antidépressifs, des anxiolytiques et des inhalants et moins susceptibles de prendre des contraceptifs oraux, des analgésiques en vente libre et des médicaments contre la toux et le rhume en vente libre.
Conclusion
Les femmes victimes de VPI n’ont pas les mêmes habitudes de consommation de médicaments que leurs concitoyennes. Les liens complexes que nous avons observés entre les problèmes de santé, l’emploi, les diagnostics et la consommation de médicaments montrent qu’il faut étudier les modes de traitement en fonction des répercussions de la violence subie au cours de la vie, de la survie économique et des exigences du rôle parental. Les médicaments ne sont qu’un des nombreux outils disponibles pour aider les femmes maltraitées à retrouver la santé.
Footnotes
Acknowledgements: This research was funded by the Canadian Institutes of Health Research, New Emerging Team Grant #106054 and Institute of Gender and Health Operating Grant #15156. The authors thank the women participants in the Women’s Health Effects Study. We also appreciate the contributions of Jacquelyn C. Campbell, Anna D. Wolf Chair & Professor, The Johns Hopkins University School of Nursing, Baltimore, MD.
References
- 1.Graffunder C, Noonan R, Cox P, Wheaton J. Through a public health lens. Preventing violence against women: An update from the US Centers for Disease Control and Prevention. J Women’s Health. 2004;13:5–16. doi: 10.1089/154099904322836401. [DOI] [PubMed] [Google Scholar]
- 2.Payne J, Neutel I, Cho R, DesMeules M. Factors associated with women’s medication use. BMC Women’s Health. 2004;4(Suppl1):S29). doi: 10.1186/1472-6874-4-S1-S29. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.British Columbia Center of Excellence in Women’s Health BCCEWH. Women, Mental Health and Mental Illness and Addiction in Canada: An Overview. 2006. Bringing women’s experience of trauma and violence into Canadian mental illness and addictions policies and programs. [Google Scholar]
- 4.Kurz D, Stark E. Not-so-benign neglect: The medical response to battering. In: Yllo K, Bograd M, editors. Feminist Perspectives on Wife Abuse. Newbury Park, CA: Sage; 1988. [Google Scholar]
- 5.Warshaw C. Limitations of the medical model in the care of battered women. In: Bart P, Moran E, editors. Violence Against Women: The Bloody Footprints. Newbury Park: Sage; 1993. [Google Scholar]
- 6.Ford-Gilboe M, Wuest J, Varcoe C, Merritt-Gray M. Developing an evidence-based health advocacy intervention to support women who have left abusive partners. Can J Nurs Res. 2006;38:147–68. [PubMed] [Google Scholar]
- 7.Parker B, McFarlane J. Nursing assessment of the battered pregnant woman. Am J Maternal Child Nurs. 1991;16:161–64. doi: 10.1097/00005721-199105000-00013. [DOI] [PubMed] [Google Scholar]
- 8.World Health Organization. ICD-10 International Statistical Classification of Diseases and Related Health Problems Manual. 2005. [Google Scholar]
- 9.National Population Health Survey Public Use Microdata File User Documentation. Ottawa, ON, 1998.
- 10.Meana M, Cho R, DesMeules M. Chronic pain: The extra burden on Canadian women. BMC Women’s Health. 2004;4(Suppl1):S17. doi: 10.1186/1472-6874-4-S1-S17. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11.Canadian Tobacco Use Monitoring Survey. Women and Smoking in Canada. Ottawa: Health Canada; 2002. [Google Scholar]
- 12.Health Canada. A Report on Mental Illnesses in Canada. 2002. [Google Scholar]
- 13.Currie J. Manufacturing Addiction: The Over-Prescription of Benzodiazepines and Sleeping Pills to Women in Canada. Vancouver, BC: British Columbia Centre of Excellence for Women’s Health; 2003. [Google Scholar]
- 14.Stewart D, Gucciardi E, Grace S. Depression. Women’s Health Surveillance Report. Ottawa, Canadian Institute of Health Information. Available online at: https://doi.org/www.phacaspc.gc.ca/pulicat/whsr-rssf/index.html (Accessed October 8, 2006).
- 15.Cairney J, Thorpe C, Rietschlin J, Avison W. 12-month prevalence of depression among single and married mothers in the 1994 National Population Health Survey. Can J Public Health. 1999;90(5):320–24. doi: 10.1007/BF03404520. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16.Caplan P. Women, Mental Health and Mental Illness and Addiction in Canada: An Overview. 2006. Women and psychiatric diagnoses. [Google Scholar]
- 17.Coker A, Davis K, Arias H, Desai S, Sanderson M, Brandt H, et al. Physical and mental health effects of intimate partner violence for men and women. Am J Prev Med. 2002;23(4):260–68. doi: 10.1016/S0749-3797(02)00514-7. [DOI] [PubMed] [Google Scholar]
- 18.Tannenbaum C, Ford AR. Women, Mental Health and Mental Illness and Addiction in Canada: An Overview. 2006. Women and psychotropic drugs. [Google Scholar]
- 19.Seeman M. Gender differences in the prescribing of antipsychotic drugs. Am J Psychiatry. 2004;161(8):1324–33. doi: 10.1176/appi.ajp.161.8.1324. [DOI] [PubMed] [Google Scholar]
- 20.Campbell J. Health consequences of intimate partner violence. Lancet. 2002;359:1331–36. doi: 10.1016/S0140-6736(02)08336-8. [DOI] [PubMed] [Google Scholar]
- 21.Statistics Canada. Canadian Community Health Survey 2.1 (2003) Public Use Microdata File User Documentation, Ottawa. 2005. [Google Scholar]