Factors Associated with Increased Analgesic Use in German Women with Endometriosis during the COVID-19 Pandemic

Abstract

(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; p = 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; p = 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; p = 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.

The Abuse and Misuse of Over-the-Counter Medicines During COVID-19

“…Second, the COVID-19 pandemic has brought stress, fear of infection and isolation, sorrow, loneliness and financial worries to many people and has caused a 25% increase in the global prevalence of mental problems such as depression, anxiety, and stress. 7 Given the association between these problems and drug abuse, 8,9 OTC medicine abuse is expected to occur more frequently. Third, poor pharmacovigilance legislation.…”

Real-World Effects of a Hyoscine Butylbromide plus Paracetamol Combination in Women with Dysmenorrhea: A Patient Survey

“…While hormonal contraceptives are prescription drugs in most countries, non-steroidal anti-inflammatory drugs are often available without a prescription as over-the-counter (OTC) products enabling women to self-manage their condition. Accordingly, many women (36-70%) manage their dysmenorrhea by self-medication often involving mefenamic acid, ibuprofen, or paracetamol [7,8].…”

Practices and Behaviors Regarding the Use of Analgesics

“…over-thecounter (OTC) self-medication is a convenient way to manage some health issues, older persons may be at higher risk of experiencing medication-related problems, the pharmacy is the most commonly reported purchase location to buy OTC medication, and Physicians are the most commonly reported information source for OTC medications (Paliwal et al, 2021). Healthcare providers should be aware of the possible factors related to increased analgesic to identify persons at risk for the misuse of pain medication and to prevent potential adverse effects (Schwab et al, 2022). There is a lack of consensus on how to manage pain using opioid analgesics (Singh et al, 2019).…”