Obtainment of prescribed analgesics among patients with Lyme neuroborreliosis; a nationwide, population-based matched cohort study
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Radicular pain is the most predominant symptom among adults with Lyme neuroborreliosis (LNB) but the duration preceding and following diagnosis remains unknown. We aimed to investigate whether patients with LNB have increased obtainment of analgesics before and after diagnosis and for how long.
Methods
We performed a nationwide, population-based, matched cohort study (2009–2021). all Danish residents with LNB (positive Borrelia burgdorferi intrathecal antibody index test and cerebrospinal fluid pleocytosis) were included. To form a comparison cohort, individuals from the general population were randomly extracted and matched 10:1 to patients with LNB on age and sex. Outcomes were obtainment of simple analgesics, antiepileptics, tricyclic antidepressants, serotonin and noradrenaline reuptake inhibitors, tramadol, and other opioids. We calculated monthly and six-monthly proportions of individuals with obtainment of analgesics and absolute risk differences.
Results
1,056 patients with LNB and 10,560 comparison cohort members were included. An increased proportion of patients with LNB obtained analgesics from 3 months before study inclusion, especially simple analgesics, tramadol, and other opioids. Within the 0–1-month period after study inclusion, patients with LNB most frequently obtained simple analgesics (15 %), antiepileptics (11 %), and tramadol (10 %). Thereafter, obtainment of analgesics declined within a few months. A slightly larger proportion of patients with LNB obtained antiepileptics up to 2.5 years after diagnosis.
Conclusions
Up to 3 months preceding diagnosis, LNB was preceded by increased obtainment of analgesics, which suggests diagnostic delay. Importantly, most patients with LNB did not obtain analgesics after the immediate disease course, although obtainment remained more frequent up to 2.5 years after.
| Originalsprog | Engelsk |
|---|---|
| Artikelnummer | 102371 |
| Tidsskrift | Ticks and Tick-borne Diseases |
| Vol/bind | 15 |
| Udgave nummer | 6 |
| Antal sider | 8 |
| ISSN | 1877-959X |
| DOI | |
| Status | Udgivet - 2024 |
Bibliografisk note
Funding Information:
Part of the data in this study was presented at the 4th NordTick conference in April 2024 in Nyborg, Denmark. The study was funded by the Independent Research Fund Denmark. MMT was supported by a grant from the Research Fund of Copenhagen University Hospital - Rigshospitalet. AML was supported by a research grant from the Lundbeck foundation. The Independent Research Fund Denmark, the Research Fund of Copenhagen University Hospital - Rigshospitalet, and the Lundbeck Foundation had no role in the design and conduct of the study; collection, management, analyses, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. MMT, LO and NO have full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. MMT was responsible for concept and statistical analyses and drafted the first version of manuscript. RBD, SE, NSA, CSJ, JB, KKS, JB, ACN, and JKM were responsible for the data collection and edited the manuscript. LHO and NO were responsible for statistical analyses, concept and edited the manuscript. AML were responsible for concept and edited the manuscript. All authors contributed to the data interpretation. All authors amended and approved the final version of the manuscript. MMT assumes full responsibility for the integrity of the submission, from inception to published article. MMT has received travel grants outside this work from GlaxoSmithKline Pharma A/S. RBD has advisory board activity with Pfizer. AML reports speakers\u2019 honorarium/travel grants/advisory board activity and unrestricted grant from Gilead, speakers honorarium /travel grants from GSK, speaker's honorarium/advisory board activity from Pfizer outside this work. AML was supported by a grant from the Lundbeck foundation. None of the authors report any conflict of interests in connection with this article. The study was approved by the Danish Data Protection Agency and the National Board of Health. Studies based on data from Danish national registries, do not require informed consent from study participants according to Danish law. The ethical approval of this study from the Danish Data Protection Agency states the data that has been used in this article cannot be shared publicly.
Publisher Copyright:
© 2024 The Author(s)
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