Correlates of opioid and benzodiazepine co-prescription among people living with HIV in British Columbia, Canada: A population-level cohort study

被引：7

作者：

Parent, Stephanie ^{[1
]}

Nolan, Seonaid ^{[2
]}

Fairbairn, Nadia ^{[2
]}

Ye, Monica ^{[1
]}

Wu, Anthony ^{[1
]}

Montaner, Julio ^{[1
,3
]}

Barrios, Rolando ^{[1
,4
,5
]}

Ti, Lianping ^{[2
,3
]}

Daly, Patty ^{[6
]}

Gilbert, Mark ^{[7
,8
]}

Gustafson, Reka ^{[6
]}

Kendall, Perry R. W. ^{[9
,10
]}

Panessa, Ciro ^{[9
]}

McGowan, Gina ^{[9
]}

South, Nancy ^{[9
]}

Heath, Kate ^{[11
]}

Hogg, Robert S. ^{[11
]}

Montaner, Julio S. G. ^{[11
]}

Barrios, Rolando ^{[1
,4
,5
]}

Daly, Patty ^{[6
]}

Gilbert, Mark ^{[7
,8
]}

Gustafson, Reka ^{[6
]}

Kendall, Perry R. W. ^{[9
,10
]}

Panessa, Ciro ^{[9
]}

Hogg, Robert S. ^{[11
]}

Montaner, Julio S. G. ^{[11
]}

机构：

[1] St Pauls Hosp, British Columbia Ctr Excellence HIV AIDS, 608-1081 Burrard St, Vancouver, BC V6Z 1Y6, Canada

[2] British Columbia Ctr Subst Use, 400-1045 HOwe St, Vancouver, BC V6Z 2A9, Canada

[3] Univ British Columbia, St Pauls Hosp, Dept Med, 608-1081 Burrard St, Vancouver, BC V6Z 1Y6, Canada

[4] Vancouver Coastal Hlth, 520 West 6th Ave, Vancouver, BC V6Z 4H5, Canada

[5] Univ British Columbia, Sch Populat & Publ Hlth, Vancouver, BC, Canada

[6] Vancouver Coastal Hlth Author, Vancouver, BC, Canada

[7] BC Ctr Dis Control, Clin Prevent Serv, Vancouver, BC, Canada

[8] Univ British Columbia, Sch Populat & Publ Hlth, Vancouver, BC, Canada

[9] British Columbia Minist Hlth, Victoria, BC, Canada

[10] Univ British Columbia, Fac Med, Vancouver, BC, Canada

[11] BC Ctr Excellence HIV AIDS, Vancouver, BC, Canada

来源：

INTERNATIONAL JOURNAL OF DRUG POLICY | 2019年 / 67卷

基金：

美国国家卫生研究院;

关键词：

People living with HIV; Opioids; Benzodiazepines; Co-prescription; Polypharmacy; Canada; CONCURRENT USE; CHRONIC PAIN; THERAPY; ANXIETY; CARE; GUIDELINE; INDIVIDUALS; MANAGEMENT; BARRIERS; ACCESS;

D O I：

10.1016/j.drugpo.2019.01.021

中图分类号：

R194 [卫生标准、卫生检查、医药管理];

学科分类号：

摘要：

Background:Co-prescribing benzodiazepines and opioids is relatively contraindicated due to the possible overdose risk. However, people living with HIV (PLWH) may have concurrent psychiatric and/or chronic pain diagnoses that may lead to the use of opioids and/or benzodiazepines for symptomatic treatment. Consequently, some PLWH may be at-risk for the health harms associated with the co-prescribing of these medications. Given this, the objectives of this study were to first examine the prevalence of opioids and benzodiazepines co-prescribing, and second, to characterize patient factors associated with the co-prescribing of opioids and benzodiazepines among PLWH in British Columbia (BC), Canada. Methods:Using data derived from a longitudinal BC cohort, we used bivariable and multivariable generalized estimating equation models to establish the prevalence of a benzodiazepine and opioid co-prescription and determine factors associated with this practice. Results:Between 1996 and 2015, 14 484 PLWH were included in the study and were followed for the entire study period. At baseline, 548 people (4%) were co-prescribed opioids and benzodiazepines, 6593 (46%) were prescribed opioids only, 2887 (20%) were prescribed benzodiazepines only, and 4456 (31%) were prescribed neither medication. A total of 3835 (27%) participants were prescribed both medications at least once during the study period. Factors positively associated with concurrent opioid and benzodiazepine prescribing included: depression/mood disorder [adjusted odds ratio (AOR) = 1.32; 95% confidence interval (CI) = 1.22-1.43] and anxiety disorder (AOR = 1.45; 95% CI = 1.27-1.66), whereas female sex (AOR = 0.76; 95% CI = 0.64-0.91) and substance use disorder (SUD) (AOR = 0.82; 95% CI = 0.74-0.90) were negatively associated with the outcome. Conclusion:Our findings indicate that co-prescription of opioids and benzodiazepines was seen at some point during study follow-up in over a quarter of PLWH. Given the known risks associated with this prescribing practice, future research can focus on the outcomes of co-prescribing among this patient population and the development of strategies to reduce the co-prescribing of opioids and benzodiazepines.

引用

页码：52 / 57

页数：6

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