Prescription and nonprescription analgesic use in Sweden

OBJECTIVE: To analyze patterns of prescription and nonprescription analgesic use in the general Swedish population, in association with predisposing factors, enabling factors, need, and health behavior. DESIGN: Cross-sectional interview survey. SETTING: The Swedish Surveys of Living Conditions for the 2-year period 1988-1989. PARTICIPANTS: A probability sample of all inhabitants of Sweden aged 18-84 years (n = 11996). MAIN OUTCOME MEASURES: Prescription and nonprescription analgesic use during a 2-week period. RESULTS: Women reported use of analgesics both with and without prescriptions to a greater extent than did men. Among women, 12.2% reported prescription analgesic use and 30.4% reported nonprescription analgesic use. The corresponding proportions among men were 7.2% and 20.0%, respectively. In the descriptive analyses, prescription analgesic use was most common among persons aged 45 years and older, while use of nonprescription analgesics was most common in people aged 18-44 years. The polychotomous logistic regression analyses showed that headache and musculoskeletal pain were strongly associated with prescription analgesic use to a similar extent among men and women. Headache was associated with nonprescription analgesic use among men and women, but a gender difference was found in the association between musculoskeletal pain and nonprescription analgesic use. Women with musculoskeletal pain used nonprescription analgesics to a greater extent than did men with musculoskeletal pain. Poor health--measured as self-perceived health status and physical function--and high use of health care were related only to prescription analgesic use. Smoking and being overweight were associated with prescription analgesic use among men and with nonprescription analgesic use among women; alcohol consumption was associated with both types of analgesic use only among women. CONCLUSIONS: This study shows that men and women differ in their choice between prescription and nonprescription analgesics and that the choice between prescription and nonprescription analgesics is influenced by an individual's pain, self-perceived health, and lifestyle.