Psychotropic medicine utilization in Australian workers with workers' compensation claims for back and neck
Yonas Getaye Tefera1, Suzanne Nielsen2, Shannon Gray1
1Healthy Working Lives Research Group, School of Public Health and Preventive Medicine, Monash University, Australia.
Aims:
To characterize psychotropic medicine utilization and identify its correlates in injured Australian workers with back and neck-related conditions following a workers' compensation claim.
Methods:
Psychotropic medicine utilization (antidepressants, gabapentinoids, anxiolytics, hypnotics/sedatives and antipsychotics) was examined among 22 595 injured workers with accepted claims (2010-2016) in Victoria, Australia, over three years post-claim. The defined daily dose (DDD) per 1000 workers per day was used to describe utilization and temporal trends. Zero-inflated negative binomial regression was employed to identify its determinants.
Results:
The overall utilization (DDD/1000/day) of psychotropics for all-injured workers was 135.4 (CI: 128.8-142.1), highest for antidepressants (74.2, CI: 70-78.5), followed by gabapentinoids (31.6, CI: 29.7-33.5), anxiolytics (16.1, CI: 14.7-17.6), hypnotics/sedatives (10.6, CI: 9.4-11.8) and antipsychotics (2.9, CI: 2.3-3.4). Workers with longer periods of disability showed increasing utilization across each medicine group and for psychotropic medications overall. Middle age was associated with higher utilization while higher socioeconomic status and living regionally were associated with lower psychotropic utilization. Gabapentinoid utilization (more than doubled (109.2%) from 20.7 in 2010 to 43.3 in 2016. Conversely, anxiolytics and hypnotics/sedatives utilization showed a relative decrease over the study period. The utilization of psychotropics increased among injured workers across the course of their claim.
Conclusions:
Psychotropic medicine utilization in compensated Australian workers with back or neck conditions was high, particularly in those with longer disability duration. Psychotropic prescribing has changed over time, with a notable increase in gabapentinoid utilization. Furthermore, a trend indicating long-term or higher-dose use of psychotropics was observed, raising concerns of potential overuse.
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