Application for disability pension and change in use of prescribed drugs. A regional Danish cohort study

Abstract

Aim: To investigate if a pending application for disability pension had an influence on the applicant's purchase of medical drugs, with a particular focus on musculoskeletal disorders and the use of painkillers. Methods: We performed a registry-based follow-up study including 12,020 applicants for disability pension in a Danish county from 1995 to 2000 and linked this information to a database of drug prescriptions. Purchase of drug was calculated for the 6-month period just before the decision and for the 6-month period 2 years later. Changes in a 2-year time period were estimated by differences in purchase rates. Furthermore, the proportion of applicants with an increased purchase of drugs and the proportion of applicants who ceased buying drugs were estimated. The results were stratified by diagnosis and result of application (awarded/rejected). The analyses were furthermore restricted to musculoskeletal disorders and the use of painkillers. Results and conclusions: At baseline 81% had a purchase and after the 2-year time period 11% ceased buying prescribed drugs. Half of all applicants increased the purchase of drugs. For musculoskeletal disorders one third had an increased purchase rate of painkillers while one fourth ceased purchase of drugs with variations in different diagnostic subgroups. The major changes of drug purchase after a pending application for disability pension are probably ascribed to characteristics of the diseases underlying the disability.

Keywords

Analgesic disabled persons drug utilisation follow-up studies insurance disability musculoskeletal diseases rehabilitation pensions registries

Get full access to this article

View all access options for this article.

References

Hadler NM If you have to prove you are ill, you can't get well. The object lesson of fibromyalgia. Spine 1996;21:2397-400.

Harris I. , Mulford J. , Solomon M. , van Gelder JM , Young J. Association between compensation status and outcome after surgery: a meta-analysis . JAMA 2005;293:1644-52.

Mobbs RJ , Gollapudi PR , Chandran NK Outcome following anterior cervical discectomy in compensation patients . J Clin Neurosci 2001;8:124-5.

Nicholson GP Arthroscopic acromioplasty: a comparison between workers' compensation and non-workers' compensation populations. J Bone Joint Surg Am 2003;85-A:682-9.

Rasmussen C. , Rechter L. , Schmidt I. , Hansen VK , Therkelsen K. The association of the involvement of financial compensation with the outcome of cervicobrachial pain that is treated conservatively . Rheumatology (Oxford) 2001;40:552-4.

Becker N. , Hojsted J. , Sjogren P. , Eriksen J.

Sociodemographic predictors of treatment outcome in chronic non-malignant pain patients. Do patients receiving or applying for disability pension benefit from multidisciplinary pain treatment?

Pain 1998;77:279-87.

Drew D. , Drebing CE , Van Ormer A. , Losardo M. , Krebs C. , Penk W. , et al. Effects of disability compensation on participation in and outcomes of vocational rehabilitation. Psychiatr Serv 2001;52:1479-84.

Lysgaard AP , Fonager K. , Nielsen CV Effect of financial compensation on vocational rehabilitation. J Rehabil Med 2005;37:388-91.

Disability Pension. Annual Statistics 1997. National Social Appeals Board. [Accessed 1 July 2008]. Available from: www.dsa.dk/publikationer/statistikker/foertidspension .

10.

Disability Pension. Annual Statistics 1999. National Social Appeals Board. [Accessed 1 July 2008] . Available from: www.dsa.dk/publikationer/statistikker/foertidspension .

11.

Consumption and statistics [homepage on the Internet]. The Danish Medicines Agency [Lægemiddelstyrelsen] [updated 2006; accessed 1 December 2006]; Available from: www.laegemiddelstyrelsen.dk.

12.

Gaist D. , Sørensen HT , Hallas J. The Danish Prescription Registries. Dan Med Bull 1997;44:445-8.

13.

About the ATC/DDD system [homepage on the Internet]. WHO Collaborating Centre for Drug Statistics Methodology [updated 28 June 2007; accessed 16 July 2007]; Available from: http://www.whocc.no/atcddd.

14.

Ejlertsson G. , Eden L. , Leden I. Predictors of positive health in disability pensioners: a population-based questionnaire study using Positive Odds Ratio . BMC Public Health 2002 ;2:20.

15.

West SL , Savitz DA , Koch G. , Strom BL , Guess HA , Hartzema A. Recall accuracy for prescription medications: self-report compared with database information. Am J Epidemiol 1995;142:1103-12.