| アブストラクト | AIM: This study aimed to evaluate the association between opioid-related deaths and persistent opioid utilisation in the United Kingdom (UK). METHODS: This nested case-control study used the UK Clinical Practice Research Datalink, linking the Office for National Statistics death registration. Adult opioid users with recorded opioid-related death between 2000 and 2015 were included and matched to four opioid users (controls) based on a disease risk score. Persistent opioid utilisation (opioid prescriptions >/=3 quarters/year and oral morphine equivalent dose >/=4500 mg/year) and psychotropic prescriptions were identified annually during the three patient-years before the date of opioid-related death. Conditional logistic regression was used to assess the association between persistent opioid utilisation and opioid-related death, and the results were reported as adjusted odds ratios (aOR) and 95% confidence intervals (95% CI). RESULTS: Of the 902 149 opioid users, 230 opioid-related deaths (cases) and 920 controls were identified. Persistent opioid utilisation was significantly associated with an increased risk of opioid-related deaths (aOR 1.9, 95% CI 1.2, 2.9) when persistent opioid utilisation was defined by both annual dose and number of quarters. Concurrent prescription of opioids and tricyclic antidepressants (aOR 2.0, 95% CI 1.2, 3.5) or higher dose of benzodiazepine (aOR 6.5, 95% CI 4.0, 10.4) or gabapentinoids (aOR 6.2, 95% CI 2.9, 13.5) were associated with opioid-related death. CONCLUSION: Persistent opioid prescribing and concurrent prescribing of psychotropics were associated with a higher risk of opioid-related death and should be avoided in clinical practice. An evidence-based indicator to monitor the safety of prescribed opioids during opioid deprescribing is needed. |
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| 投稿日 | 2021/8/10 |
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| 投稿者 | Chen, Teng-Chou; Knaggs, Roger David; Chen, Li-Chia |
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| ジャーナル名 | British journal of clinical pharmacology |
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| 組織名 | Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and;Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health,;University of Manchester, Manchester Academic Health Science Centre.;Division of Pharmacy Practice and Policy, School of Pharmacy, University of;Nottingham, Nottingham, UK.;Primary Integrated Community Solutions, Nottingham Business Park, Nottingham, UK.;Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/34371521/ |
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