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Impact of hysterectomy on analgesic, psychoactive and neuroactive drug use in women with endometriosis: nationwide cohort study
Author(s) -
Brunes M,
Altman D,
Pålsson M,
Söderberg MW,
Ek M
Publication year - 2021
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.16469
Subject(s) - endometriosis , medicine , medical prescription , hysterectomy , population , analgesic , cohort , cohort study , obstetrics , gynecology , surgery , anesthesia , pharmacology , environmental health
Objective To evaluate how hysterectomy affects the prescription of analgesic, psychotropic and neuroactive drugs in women with endometriosis using population‐based nationwide registers. Design Nationwide cohort study. Setting Swedish national registers, from 1 January 2009 to 31 December 2018. Population Women with benign disease undergoing a total hysterectomy during the 4‐year period of 2012–2015. Women with endometriosis ( n = 1074) were identified and compared with women who did not have endometriosis ( n = 10 890). Methods Prospectively collected data from two population‐based registers were linked: the Swedish National Quality Register of Gynaecological Surgery and the Swedish National Drug Register. Multivariate logistic regression was used as the main statistical method. Main outcome measures Changes in drug prescription over time for 3 years prior to and 3 years after hysterectomy. Results The frequency of prescription of analgesics was higher in women with endometriosis compared with women without endometriosis (OR 2.2, 95% CI 1.7–2.9). Among women with endometriosis, the prescription of analgesics (OR 1.0, 95% CI 0.8–1.2) did not decrease 3 years after hysterectomy compared with the 3 years prior to surgery. There was also a significantly higher rate of prescription of psychoactive (OR 1.6, 95% CI 1.4–2.0) and neuroactive drugs (OR 1.9, 95% CI 1.3–2.7) in the long term postoperatively. Conclusions In women undergoing hysterectomy, endometriosis was associated with a higher prescription rate of analgesics. In the endometriosis group the prescription of analgesic, psychoactive and neuroactive drugs did not decrease when comparing prescription rates for the 3 years prior to and the 3 years after surgery. Tweetable abstract In women with endometriosis, the long‐term prescription of analgesics did not decrease after hysterectomy.