Hasseleid Synva Nesheim, Clench-Aas Jocelyne, Raanaas Ruth Kjærsti, Lundqvist Christofer
Section for Public Health Science, Department of Landscape Architecture and Spatial Planning, Norwegian University of Life Sciences, Ås, Norway.
Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.
Scand J Pain. 2017 Jul;16:114-121. doi: 10.1016/j.sjpain.2017.04.069. Epub 2017 May 25.
Over the last years, concern has been expressed about adolescents' possible liberal attitude towards - and use of - non-prescription analgesics. A high consumption of analgesics is unfortunate as it may lead to various harmful effects and worsening of headache. In order to address this challenge, it is necessary to achieve a more extensive knowledge about adolescent consumption. The main aim of this study was to examine the association between adolescent and parental use of non-prescription analgesics, taking into account headache as well as other somatic pain. The effects of parental prescription analgesics use was a secondary aim.
The study is based on data from two cross-sectional health studies conducted in 2005 and 2012 in Norway, including 646 adolescents and an accompanying parent. By using sample weights, the final weighted sample used in the analysis was 1326. Data was collected through postal questionnaires to parents and adolescents as well as parental telephone interviews. Questionnaires included questions on different pain locations and the pain for each location was graded according to how troubling the pain was. Medication data on prescription and non-prescription analgesics was from telephone interviews and was quantified based on the pattern over the past 4 weeks. Multivariate logistic regression models and complex samples analyses were used.
20% of adolescents were reported as using non-prescription analgesics during the previous 4 weeks. Girls were more often reported to use non-prescription analgesics than boys. Headache and all other somatic pain locations except back pain were reported more frequently among girls while boys more frequently reported back pain. There was a clear association between the use of non-prescription analgesics and headache with 34% of adolescents with headache using non-prescription analgesics versus 19% of adolescents with other somatic pain and 14% of adolescents not reporting pain. Among adolescents reporting headache, 9% were reported to use non-prescription analgesics daily or almost daily versus 3% and 2% among those reporting other somatic pain and reporting no pain respectively. In addition, parental use of non-prescription analgesics was a strong independent predictor of adolescent use (adjusted OR 1.69 for boys, 1.54 for girls). This relationship increased when the adolescents were less bothered by headache themselves.
Headache is the dominant medication-driving pain for non-prescription analgesics among adolescents but parental medication use of non-prescription analgesics also strongly influences adolescent use.
There is a need for health services to improve information to parents and adolescents about risks associated with use of analgesics and also to work on prophylactic strategies focusing on adolescents. Parents should be made aware that their medicine use strongly influences that of their children.
在过去几年中，人们对青少年对待非处方镇痛药可能持有的随意态度及其使用情况表示担忧。大量服用镇痛药是令人遗憾的，因为这可能导致各种有害影响并使头痛加重。为应对这一挑战，有必要更广泛地了解青少年的用药情况。本研究的主要目的是考察青少年与父母使用非处方镇痛药之间的关联，同时考虑头痛以及其他身体疼痛情况。父母使用处方镇痛药的影响是次要目的。
本研究基于2005年和2012年在挪威进行的两项横断面健康研究的数据，包括646名青少年及其一位陪同家长。通过使用样本权重，分析中使用的最终加权样本为1326。数据通过向家长和青少年邮寄问卷以及对家长进行电话访谈收集。问卷包括关于不同疼痛部位的问题，每个部位的疼痛根据其困扰程度进行分级。关于处方和非处方镇痛药的用药数据来自电话访谈，并根据过去4周的用药模式进行量化。使用了多变量逻辑回归模型和复杂样本分析。
据报告，20%的青少年在过去4周内使用过非处方镇痛药。报告显示女孩比男孩更常使用非处方镇痛药。女孩报告头痛和除背痛外的所有其他身体疼痛部位的频率更高，而男孩报告背痛的频率更高。使用非处方镇痛药与头痛之间存在明显关联，34%的头痛青少年使用非处方镇痛药，而有其他身体疼痛的青少年这一比例为19%，无疼痛报告的青少年为14%。在报告头痛的青少年中，9%的人被报告每天或几乎每天使用非处方镇痛药，而报告有其他身体疼痛和无疼痛报告的青少年中这一比例分别为3%和2%。此外，父母使用非处方镇痛药是青少年用药的一个强有力的独立预测因素（男孩调整后的比值比为1.69，女孩为1.54）。当青少年自身头痛困扰较小时，这种关系更为明显。
头痛是青少年使用非处方镇痛药的主要用药驱动性疼痛，但父母使用非处方镇痛药也对青少年用药有强烈影响。
卫生服务机构需要改善向家长和青少年提供的关于镇痛药使用相关风险的信息，并致力于针对青少年的预防策略。应让家长意识到他们的用药情况对孩子有很大影响。
