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High use of pain, depression, and anxiety drugs in hemophilia : more than 3000 people with hemophilia in an 11-year Nordic registry study

Steen Carlsson, Katarina LU orcid ; Winding, Bent ; Astermark, Jan LU ; Baghaei, Fariba ; Brodin, Elisabeth ; Funding, Eva LU ; Holmström, Margareta ; Österholm, Klaus ; Bergenstråle, Sofia and Lethagen, Stefan LU (2023) In Research and practice in thrombosis and haemostasis 7(2).
Abstract

Background: Pain is a common feature of hemophilia, but prevalence of depression and anxiety is less studied. Registry data on prescription drugs can provide an objective measure of the magnitude of these complications. Objectives: To identify treatment patterns of prescribed pain, antidepressant, and antianxiety medications compared with those of matched controls in 4 Nordic countries. Methods: The MIND study (NCT03276130) analyzed longitudinal individual-level national data during 2007-2017. People with hemophilia (PwH) were identified from National Health Data Registers by diagnosis or factor replacement treatment and compared with population controls. Three subgroups were defined by the use of factor concentrates and sex... (More)

Background: Pain is a common feature of hemophilia, but prevalence of depression and anxiety is less studied. Registry data on prescription drugs can provide an objective measure of the magnitude of these complications. Objectives: To identify treatment patterns of prescribed pain, antidepressant, and antianxiety medications compared with those of matched controls in 4 Nordic countries. Methods: The MIND study (NCT03276130) analyzed longitudinal individual-level national data during 2007-2017. People with hemophilia (PwH) were identified from National Health Data Registers by diagnosis or factor replacement treatment and compared with population controls. Three subgroups were defined by the use of factor concentrates and sex (moderate-to-high factor consumption (factor VIII [FVIII] use of ≥40 IU/kg/week or FIX use of ≥10 IU/kg/week), low factor consumption, and women including carriers). Results: Data of 3246 PwH, representing 30,184 person-years, were analyzed. PwH (including children and adults) used more pain, depression, and anxiety medications compared with controls. This was most accentuated in the moderate-to-high factor consumption group and notably also observed in men with low factor consumption and women including carriers, usually representing a milder phenotype. A higher opioid use was observed across all age groups: 4- to 6-fold higher in the moderate-to-high factor consumption group and 2- to 4-fold higher in the low factor consumption group. Conclusion: The consistent higher use of pain, depression, and anxiety medications among PwH compared with population controls, regardless of age, sex, or factor consumption, in broad national data suggests a need for improved bleed protection and hemophilia care for all severities including mild hemophilia.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
analgesics, opioid, anxiety, case-control studies, depression, drug utilization, female, hemophilia A, hemophilia B, pain, prescription drugs
in
Research and practice in thrombosis and haemostasis
volume
7
issue
2
article number
100061
publisher
Wiley
external identifiers
  • pmid:36908766
  • scopus:85149384289
ISSN
2475-0379
DOI
10.1016/j.rpth.2023.100061
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2023 The Author(s)
id
c016f7d1-f97c-4dd8-be0f-003ef96750e8
date added to LUP
2024-01-12 13:59:52
date last changed
2024-04-13 08:09:55
@article{c016f7d1-f97c-4dd8-be0f-003ef96750e8,
  abstract     = {{<p>Background: Pain is a common feature of hemophilia, but prevalence of depression and anxiety is less studied. Registry data on prescription drugs can provide an objective measure of the magnitude of these complications. Objectives: To identify treatment patterns of prescribed pain, antidepressant, and antianxiety medications compared with those of matched controls in 4 Nordic countries. Methods: The MIND study (NCT03276130) analyzed longitudinal individual-level national data during 2007-2017. People with hemophilia (PwH) were identified from National Health Data Registers by diagnosis or factor replacement treatment and compared with population controls. Three subgroups were defined by the use of factor concentrates and sex (moderate-to-high factor consumption (factor VIII [FVIII] use of ≥40 IU/kg/week or FIX use of ≥10 IU/kg/week), low factor consumption, and women including carriers). Results: Data of 3246 PwH, representing 30,184 person-years, were analyzed. PwH (including children and adults) used more pain, depression, and anxiety medications compared with controls. This was most accentuated in the moderate-to-high factor consumption group and notably also observed in men with low factor consumption and women including carriers, usually representing a milder phenotype. A higher opioid use was observed across all age groups: 4- to 6-fold higher in the moderate-to-high factor consumption group and 2- to 4-fold higher in the low factor consumption group. Conclusion: The consistent higher use of pain, depression, and anxiety medications among PwH compared with population controls, regardless of age, sex, or factor consumption, in broad national data suggests a need for improved bleed protection and hemophilia care for all severities including mild hemophilia.</p>}},
  author       = {{Steen Carlsson, Katarina and Winding, Bent and Astermark, Jan and Baghaei, Fariba and Brodin, Elisabeth and Funding, Eva and Holmström, Margareta and Österholm, Klaus and Bergenstråle, Sofia and Lethagen, Stefan}},
  issn         = {{2475-0379}},
  keywords     = {{analgesics, opioid; anxiety; case-control studies; depression; drug utilization; female; hemophilia A; hemophilia B; pain; prescription drugs}},
  language     = {{eng}},
  number       = {{2}},
  publisher    = {{Wiley}},
  series       = {{Research and practice in thrombosis and haemostasis}},
  title        = {{High use of pain, depression, and anxiety drugs in hemophilia : more than 3000 people with hemophilia in an 11-year Nordic registry study}},
  url          = {{http://dx.doi.org/10.1016/j.rpth.2023.100061}},
  doi          = {{10.1016/j.rpth.2023.100061}},
  volume       = {{7}},
  year         = {{2023}},
}