Schwab Roxana, Stewen Kathrin, Kottmann Tanja, Schmidt Mona W, Anic Katharina, Theis Susanne, Hamoud Bashar Haj, Elger Tania, Brenner Walburgis, Hasenburg Annette
Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany.
CRO Dr. med Kottmann GmbH & Co. KG, 59077 Hamm, Germany.
J Clin Med. 2022 Sep 21;11(19):5520. doi: 10.3390/jcm11195520.
(1) Background: Endometriosis is a frequent chronic pain condition in women of fertile age. Pain management with analgesics is frequently used by women with endometriosis. During the COVID-19 pandemic, access to health services was temporarily restricted in various countries for persons without serious conditions, resulting in increased physical and mental health issues. The present study was conducted in order to assess the risk factors predicting increased analgesic intake by women with endometriosis during the COVID-19 pandemic. (2) Methods: The increased intake of over-the-counter (OTC) and prescription-only (PO) analgesics was assessed with an anonymous online questionnaire, along with demographic, pandemic-specific, disease-specific, and mental health characteristics. Anxiety and depression were assessed with the Generalized Anxiety Disorder Scale (GAD-2) and the Patient Health Questionnaire for Depression (PHQ-2), respectively. Pain-induced disability was assessed with the pain-induced disability index (PDI). (3) Results: A high educational level (OR 2.719; 95% CI 1.137-6.501; = 0.025) and being at higher risk for depressive disorders, as measured by PHQ-2 ≥ 3 (OR 2.398; 95% CI 1.055-5.450; = 0.037), were independent risk factors for an increased intake of OTC analgesics. Current global pain-induced disability (OR 1.030; 95% CI 1.007-1.054; = 0.010) was identified as a risk factor for an increased intake of PO pain medication. The degree of reduction in social support and in social networks were independent predictors of an increased intake of PO analgesics in a univariate logistic regression analysis, but lost significance when adjusted for additional possible influencing factors. (4) Conclusions: In this population, an increased intake of OTC analgesics was related to a higher educational level and having a depressive disorder, while a higher pain-induced disability was an independent risk factor for an increased intake of PO analgesics. Pandemic-specific factors did not significantly and independently influence an increased intake of analgesics in women with endometriosis during the first wave of the COVID-19 pandemic in Germany. Healthcare providers should be aware of the possible factors related to increased analgesic use in women with endometriosis in order to identify persons at risk for the misuse of pain medication and to prevent potential adverse effects.
（1）背景：子宫内膜异位症是育龄女性常见的慢性疼痛病症。子宫内膜异位症患者常使用镇痛药进行疼痛管理。在新冠疫情期间，各国对无严重病情的人员临时限制了医疗服务的获取，这导致身心健康问题增多。开展本研究旨在评估预测新冠疫情期间子宫内膜异位症女性镇痛药摄入量增加的风险因素。（2）方法：通过匿名在线问卷评估非处方（OTC）和仅处方（PO）镇痛药摄入量的增加情况，以及人口统计学、疫情相关、疾病相关和心理健康特征。分别使用广泛性焦虑障碍量表（GAD - 2）和患者抑郁健康问卷（PHQ - 2）评估焦虑和抑郁情况。使用疼痛导致的残疾指数（PDI）评估疼痛引起的残疾情况。（3）结果：高学历水平（比值比[OR]2.719；95%置信区间[CI]1.137 - 6.501；P = 0.025）以及根据PHQ - 2≥3测量的患抑郁症风险较高（OR 2.398；95% CI 1.055 - 5.450；P = 0.037）是OTC镇痛药摄入量增加的独立风险因素。当前全球疼痛导致的残疾（OR 1.030；95% CI 1.007 - 1.054；P = 0.010）被确定为PO镇痛药摄入量增加的一个风险因素。在单因素逻辑回归分析中，社会支持和社交网络减少的程度是PO镇痛药摄入量增加的独立预测因素，但在调整其他可能的影响因素后失去了显著性。（4）结论：在这一人群中,OTC镇痛药摄入量增加与高学历水平和患有抑郁症有关，而较高的疼痛导致的残疾是PO镇痛药摄入量增加的独立风险因素。在德国新冠疫情第一波期间，疫情相关因素并未显著且独立地影响子宫内膜异位症女性镇痛药摄入量的增加。医疗服务提供者应了解与子宫内膜异位症女性镇痛药使用增加相关的可能因素，以便识别有滥用止痛药风险的人群并预防潜在的不良影响。
