School of Pharmacy, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
Division of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico.
JCO Glob Oncol. 2023 Sep;9:e2300008. doi: 10.1200/GO.23.00008.
To evaluate the association between concurrent use of opioids and benzodiazepines (BZDs) and emergency room (ER) visits and hospital admissions in patients with cancer.
Data were obtained from the Puerto Rico Central Cancer Registry-Health Insurance Linkage. Odds ratios (ORs) with 95% CIs and incidence rate ratio (IRR) were estimated using logistic and negative binomial regression analyses to assess the association between concurrent use of opioids and BZDs (overlap of at least 7 days) and ER visits and hospital admissions.
A total of 9,259 patients were included in the main analysis. The logistic regression results showed a significant association between concurrent use of opioids and BZDs and at least one ER visit (OR, 1.28 [95% CI, 1.07 to 1.54]) or hospital admission (OR, 1.42 [95% CI, 1.18 to 1.71]) compared with individuals with BZDs alone, after adjusting for age, sex, comorbidity index, cancer stage, health insurance, and health region. Compared with individuals with opioid use alone, the association did not reach significance. In the negative binomial regression, a significant association was observed for ER visits (IRR, 1.52 [95% CI, 1.31 to 1.76]) and hospitalizations (IRR, 1.34 [95% CI, 1.20 to 1.50]) when compared with individuals with BZDs alone. Compared with individuals with opioids alone, it only reached significance for ER visits (IRR, 1.39 [95% CI, 1.20 to 1.61]).
Careful evaluation must be done before prescribing concurrent opioids and BZDs in patients with cancer, as the results suggest that coprescribing may increase the odds of ER visits and hospitalizations.
评估癌症患者同时使用阿片类药物和苯二氮䓬类药物（BZDs）与急诊就诊和住院之间的关联。
数据来自波多黎各中央癌症登记处-医疗保险关联数据库。使用逻辑回归和负二项回归分析估计比值比（ORs）和 95%置信区间（CIs）以及发病率比（IRR），以评估同时使用阿片类药物和 BZDs（至少重叠 7 天）与急诊就诊和住院之间的关联。
共纳入 9259 例患者进行主要分析。逻辑回归结果显示，与单独使用 BZDs 的患者相比，同时使用阿片类药物和 BZDs 与至少一次急诊就诊（OR，1.28 [95%CI，1.07 至 1.54]）或住院（OR，1.42 [95%CI，1.18 至 1.71]）的关联具有统计学意义，调整了年龄、性别、合并症指数、癌症分期、医疗保险和卫生区域。与单独使用阿片类药物的患者相比，这种关联没有达到统计学意义。在负二项回归中，与单独使用 BZDs 的患者相比，急诊就诊（IRR，1.52 [95%CI，1.31 至 1.76]）和住院（IRR，1.34 [95%CI，1.20 至 1.50]）的关联具有统计学意义。与单独使用阿片类药物的患者相比，仅在急诊就诊方面达到统计学意义（IRR，1.39 [95%CI，1.20 至 1.61]）。
在为癌症患者开具同时使用阿片类药物和 BZDs 的处方之前，必须进行仔细评估，因为结果表明，同时开具这两种药物可能会增加急诊就诊和住院的几率。
