An Examination of Concurrent Opioid and Benzodiazepine Prescribing in 9 States, 2015
An Examination of Concurrent Opioid and Benzodiazepine Prescribing in 9 States, 2015
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DOI：
10.1016/j.amepre.2019.06.007
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发表时间：
2019-11-01
影响因子：
5.5
通讯作者：
Sargent, Wesley
中科院分区：
文献类型：
--
作者：
Guy, Gery P., Jr.;Zhang, Kun;Sargent, Wesley
基于证据的临床指南不鼓励同时开具阿片类药物和苯二氮卓类药物的处方，因为已知这些药物联合使用有风险。方法：本研究使用2015处方行为监测系统（一个多州去识别处方药监测项目数据数据库）分析了9个州同时开具阿片类药物和苯二氮卓类药物的情况。同时使用阿片类药物和苯二氮卓类药物的个体的处方率进行了检查。同时处方的患者，检查阿片类药物总供应天数、每日阿片类药物剂量和同时处方的总天数。通过同时开处方是来自单个开处方者还是来自多个开处方者对分析进行分层。阿片类药物处方和同时使用阿片类药物和苯二氮卓类药物的处方率按年龄和性别进行检查。2018年进行了分析。结果：在服用阿片类药物的19,977,642例患者中，21.6%（4,324,092例）同时服用苯二氮卓类药物，其中54.9%（2,375,219例）同时服用。超过一半同时服用阿片类药物和苯二氮卓类药物的患者从两个或更多不同的处方者那里获得处方。当涉及多个处方者时，患者的平均总阿片类药物天数、每日阿片类药物剂量和同时处方天数均高于同一处方者的同时处方天数。同时处方在50岁成人和女性患者中更为常见。结论：需要采取公共卫生干预措施来减少阿片类药物和苯二氮卓类药物的同时处方。以证据为基础的指南可以帮助减少一个开处方者同时开处方的情况，使用处方药监测项目和改进的护理协调可以帮助解决多名开处方者同时开处方的问题。由爱思唯尔公司代表美国预防医学杂志出版。
Introduction: Concurrent prescribing of opioids and benzodiazepines is discouraged by evidence-based clinical guidelines because of the known risks of taking these medications in combination.Methods: This study analyzed concurrent opioid and benzodiazepine prescribing in 9 states using the 2015 Prescription Behavior Surveillance System, a multistate database of de-identified prescription drug monitoring program data. Concurrent prescribing rates were examined among individuals with both an opioid and a benzodiazepine prescription. Among patients with concurrent prescribing, total days of opioid supply, daily dosage of opioids, and total days of concurrent prescriptions were examined. Analyses were stratified by whether concurrent prescribing was from a single prescriber or multiple prescribers. Opioid prescribing and concurrent opioid and benzodiazepine prescribing rates were examined by age and sex. Analyses were conducted in 2018.Results: Among 19,977,642 patients that were prescribed an opioid, 21.6% (4,324,092) were also prescribed a benzodiazepine, of which 54.9% (2,375,219) had concurrent prescriptions. More than half of patients with concurrent opioids and benzodiazepines received prescriptions from 2 or more distinct prescribers. Mean total opioid days, daily opioid dosage, and days of concurrent prescribing were higher among patients when multiple prescribers were involved compared with concurrent prescriptions from the same prescriber. Concurrent prescribing was more common among adults aged >= 50 years and female patients.Conclusions: Public health interventions are needed to reduce concurrent prescribing of opioids and benzodiazepines. Evidence-based guidelines can help reduce concurrent prescribing when one prescriber is involved, and utilization of prescription drug monitoring programs and improved care coordination could help address concurrent prescribing when multiple prescribers are involved. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine.