Table 3.
Analysis of CNCP Individuals and Predictors of Long-Term Opioid Use ≥6 Months (Group A1) versus Moderate to Short-Term Opioid Use (Group B1+C1)
| Model A Socioeconomicsa HR, Mutually Adjusted | Model B Socioeconomics, Sex, and Ageb HR, Mutually Adjusted | Model C Socioeconomics, Sex, Age, and Major Comorbid Conditionsc HR, Mutually Adjusted | |
|---|---|---|---|
| Education | |||
| Primary school (ref) | 1 | 1 | 1 |
| Secondary school | 0.90 (0.85–0.96)** | 0.91 (0.86–0.97)** | 0.95 (0.90–1.02) |
| Bachelor’s degree or higher | 0.79 (0.73–87)*** | 0.78 (0.72–85)*** | 0.85 (0.78–0.93)*** |
| Unknown | 1.09 (0.97–1.21) | 1.11 (0.99–1.24) | 1.08 (0.96–1.21) |
| Living conditions | |||
| Children at home (<25 years), yes | 0.92 (0.86–0.98)* | 0.85 (0.78–91)*** | 0.84 (0.78–0.91)*** |
| Marital status | |||
| Married | 1 | 1 | 1 |
| Widowed | 0.93 (0.85–1.02) | 0.92 (0.84–1.01) | 0.92 (0.84–1.01) |
| Divorced | 1.09 (1.00–1.18)* | 1.05 (0.97–1.14) | 1.04 (0.96–1.13) |
| Single (unmarried) | 0.95 (0.89–1.02) | 0.92 (0.85–1.00) | 0.95 (0.87–1.03) |
| Unknown marital status | 0.30 (0.04–2.27) | 0.33 (0.04–2.50) | 0.33 (0.04–2.53) |
| Living area/Municipality | |||
| Capital area 1,500,000 | 0.74 (0.49–1.11) | 0.74 (0.49–1.10) | 0.84 (0.56–1.26) |
| Larger city ≥100,000 <1,500,000 | 0.98 (0.65–1.48) | 0.98 (0.65–1.47) | 0.90 (0.60–1.36) |
| City 20,000–99,999 | 1.01 (0.67–1.51) | 1.00 (0.67–1.50) | 0.96 (0.64–1.45) |
| Small city 1000–19,999 | 0.94 (0.63–1.40) | 0.94 (0.62–1.40) | 0.91 (0.61–1.37) |
| Countryside or a village ≤999 | 0.99 (0.66–1.48) | 0.99 (0.66–1.49) | 0.95 (0.64–1.43) |
| Household income | |||
| Lowest sextile (≤150.000 Dkr) | 1.11 (0.93–1.33) | 1.09 (0.91–1.31) | 1.11 (0.92–1.34) |
| Lowest tertile (≤199.999 Dkr) (ref) | 1 | 1 | 1 |
| Middle tertile (≥200,000 but ≤400,000 Dkr) | 0.91 (0.83–0.99)* | 0.90 (0.83–0.98)* | 0.93 (0.85–1.01) |
| Highest tertile (>400,000 Dkr) | 0.85 (0.78–0.93)*** | 0.84 (0.77–0.92)*** | 0.90 (0.83–0.99)* |
| Unknown | 1.18 (0.84–1.67) | 1.14 (0.80–1.60) | 1.14 (0.81–1.61) |
| Opioid dose in mg OMEQ/day | |||
| 0–1 month (50–80,640), Mean (552.37) | 1 | 1 | 1 |
| 0–3 months (50–142,590), Mean (817.03) | 0.97 (0.97–0.97)*** | 0.97 (0.97–0.97)*** | 0.97 (0.97–0.97)*** |
| 0–6 months (50–283,711), Mean (1114.26) | 0.88 (0.82–0.94)*** | 0.88 (0.83–94)*** | 0.88 (0.83–0.94)*** |
| 0–12 months (50–402,000), Mean (1583.30) | 1.17 (1.10–1.25)*** | 1.17 (1.09–1.25)*** | 1.17 (1.09–1.24)*** |
| Sex | |||
| Male | 0.85 (0.80–0.90)*** | 0.87 (0.83–93)*** | |
| Age at inclusion, CNCP | |||
| 1st quartile (16–41 years) (ref) | 1 | 1 | |
| 2nd quartile (42–50 years) | 1.08 (0.99–1.18) | 1.09 (1.00–1.18) | |
| 3rd quartile (51–75 years) | 0.91 (0.82–1.01) | 0.92 (0.83–1.02) | |
| 4th quartile (76–110 years) | 0.90 (0.80–1.00)* | 0.85 (0.74–0.97)* | |
| Employment/Income source | |||
| Employed | 1.03 (0.88–1.19) | ||
| Retired | 1.33 (1.1.13–1.57)** | ||
| Social welfare | 1.44 (1.22–1.71)*** | ||
| Unemployed ≥ 6 monthsa | 1.20 (0.96–1.51) | ||
| Region of municipality | |||
| Capital | 0.79 (0.70–0.90)*** | ||
| Zealand | 0.92 (0.83–1.03) | ||
| Southern Denmark | 0.97 (0.88–1.06) | ||
| Central Jutland | 0.97 (0.88–1.07) | ||
| Northern Jutland | 1.06 (0.97–1.15) | ||
| Number of drugs (co-medication) | |||
| 0 (ref) | 1 | ||
| 1–3 | 0.91 (0.83–1.00)* | ||
| 4–9 | 0.87 (0.77–0.98)* | ||
| 10+ | 0.93 (0.77–1.13) | ||
| Type of co-medication | |||
| Anti-hypertension | 0.87 (0.66–1.13) | ||
| Anti-coagulation AC | 1.06 (0.96–1.16) | ||
| ACE inhibitor | 0.94 (0.85–1.03) | ||
| Ischemic heart disease | 0.59 (0.29–1.20) | ||
| Antiarrhythmics | 1.10 (0.95–1.27) | ||
| AT2 antagonists | 1.01 (0.90–1.13) | ||
| Beta-blockers | 1.06 (0.97–1.15) | ||
| Anti-diabetics | 1.20 (1.03–1.41)* | ||
| Lipid-lowering | 0.84 (0.76–93)** | ||
| Prednisolone | 1.01 (0.92–1.10) | ||
| Immunosuppressants | 0.80 (0.62–1.04) | ||
| Anti-rheumatics | 1.07 (1.00–1.14) | ||
| Joint and muscular pain | 1.13 (0.97–1.32) | ||
| Anti-epileptics | 0.91 (0.78–1.06) | ||
| Parkinson medications | 1.00 (0.80–1.26) | ||
| Other antidepressants | 1.06 (0.92–1.21) | ||
| SSRI | 0.98 (0.85–1.14) | ||
| Charlson index (numbers of comorbidity) | |||
| 0 (ref) | 1 | ||
| 1 | 0.87 (0.78–0.97)** | ||
| 2 | 0.92 (0.78–1.07) | ||
| 3+ | 0.90 (0.72–1.11) | ||
| Comobidity | |||
| Diabetes | 0.99 (0.85–1.15) | ||
| Pulmonary disease | 0.20 (0.02–2.09) | ||
| Hemiplegia | 0.77 (0.48–1.21) | ||
| Dementia | 0.92 (0.83–1.02) | ||
| Heart failure | 0.80 (0.19–3.30) | ||
| Fracture ≤90 days before the index | |||
| Spine | 0.95 (0.75–1.21) | ||
| Hip | 0.99 (0.83–1.18) | ||
| Forearm | 0.98 (0.83–1.16) | ||
| Humerus | 0.95 (0.81–1.12) | ||
| Any fracture | 0.88 (0.81–0.95)** | ||
| Surgery ≤90 days before the index | |||
| Skull/intracranial | 0.61 (0.26–1.42) | ||
| Spinal cord/nerve root | 0.75 (0.51–1.10) | ||
| Peripheral nerves | 0.88 (0.49–1.59) | ||
| Autonomic nervous system | 0.56 (0.04–8.86) | ||
| Endocrine organs | 1.13 (0.21–6.07) | ||
| Ear, nose or larynx | 1.32 (0.73–2.39) | ||
| Lips, teeth, jaw, mouth or throat | 0.64 (0.40–1.05) | ||
| Heart/large vessels in thorax | 0.88 (0.60–1.30) | ||
| Peripheral vessels/lymphatic | 0.94 (0.61–1.44) | ||
| Resp. sys., thorax, mediastinum or diaphragma | 0.91 (0.59–1.40) | ||
| Digestive organs or spleen | 1.00 (0.79–1.26) | ||
| Urin, male genitalia | 1.04 (0.66–1.65) | ||
| Female genitalia | 0.79 (0.55–1.14) | ||
| Obstetric surgery | 0.91 (0.46–1.80) | ||
| Minorb | 1.04 (0.94–1.16) | ||
| Back or neck | 0.99 (0.67–1.44) | ||
| Shoulder or upper arm | 0.77 (0.62–0.96)* | ||
| Elbow or forearm | 0.68 (0.51–0.90)** | ||
| Wrist or hand | 0.85 (0.63–1.16) | ||
| Pelvis | 1.06 (0.60–1.88) | ||
| Hip or thigh | 0.75 (0.64–0.87)*** | ||
| Knees, lower legs, ankle or foot | 0.82 (0.74–0.92)** |
Notes: aUnemployed ≥6 months: a category extracted from the other income categories. bMinor: eye, breast, skin, minor surgical procedures, endoscopies, procedures during surgery, tissue withdrawals for transplantation. cMajor comorbid conditions: diabetes, pulmonary disease, hemiplegia, dementia, heart failure. *p<0.05, **p<0.01, ***p<0.001.
Abbreviation: HR, hazard ratio.