Goicochea Shelby, Bhullar Amal, Turner Scott, Stamper Benton J, Guerrier Christina, Pomm Raymond, Leung Kitty
Psychiatry, Talkiatry, Jacksonville, USA.
Psychiatry, University of Florida College of Medicine, Jacksonville, USA.
Cureus. 2025 Mar 11;17(3):e80422. doi: 10.7759/cureus.80422. eCollection 2025 Mar.
Background and objectives The coprescription of an opioid and a sedative-hypnotic (i.e., benzodiazepine or Z-drug) is associated with negative patient outcomes. Although multiple guidelines recommend minimizing this combination, studies demonstrate high coprescribing patterns. The Area Deprivation Index (ADI), a validated surrogate measure of socioeconomic status, was used to assess socioeconomic disadvantage. The objective of this study was to evaluate the current prevalence and the relationship between coprescriptions and ADI scores of patients. Methods A single-center retrospective observational study from 2019 to 2022 of adult patients in outpatient clinics with a coprescription (i.e., ≥ 7 days overlap between an opioid prescription and a benzodiazepine or Z-drug prescription) was conducted. A negative binomial model analyzed the percentage change in the incidence of coprescription for every unit increase in national ADI. Results A total of 6,846 patients had ≥ 7 days overlap of opioid and sedative-hypnotic prescriptions, comprising a total of 83,560 coprescriptions over the four-year period. A negative binomial regression found a 1.004% increased risk of coprescription for every unit increase in national ADI (p < 0.01), indicating higher socioeconomic disadvantage. The average patient was 57 years old with an ADI of 64.1, a coprescription overlap duration of 23.8 days, and ts (MME) of 47.3. Secondary observations included a significant difference in patient ADI across insurance types (p-value < 0.001). Higher MMEs were observed in white, black, and younger patients. Conclusions This study highlights the continued prevalence of coprescriptions and their relationship to social determinants of health. A stronger association between coprescriptions among patients with greater socioeconomic disadvantage (i.e., higher ADI) was observed and underscores the importance of incorporating ADI into prescribing risk assessments.
背景与目的 阿片类药物与镇静催眠药（即苯二氮䓬类药物或Z类药物）联合处方与患者不良预后相关。尽管多项指南建议尽量减少这种联合用药，但研究表明联合处方模式仍然普遍。地区贫困指数（ADI）是一种经过验证的社会经济地位替代指标，用于评估社会经济劣势。本研究的目的是评估当前联合处方的患病率以及联合处方与患者ADI评分之间的关系。方法 对2019年至2022年门诊成年患者进行单中心回顾性观察研究，这些患者存在联合处方情况（即阿片类药物处方与苯二氮䓬类药物或Z类药物处方重叠≥7天）。采用负二项式模型分析全国ADI每增加一个单位时联合处方发生率的百分比变化。结果 共有6846例患者的阿片类药物和镇静催眠药处方重叠≥7天，在这四年期间共有83560次联合处方。负二项式回归发现，全国ADI每增加一个单位，联合处方风险增加1.004%（p<0.01），表明社会经济劣势更高。患者平均年龄为57岁，ADI为64.1，联合处方重叠持续时间为23.8天，日均吗啡当量（MME）为47.3。次要观察结果包括不同保险类型患者的ADI存在显著差异（p值<0.001）。在白人、黑人和年轻患者中观察到较高的日均吗啡当量。结论 本研究突出了联合处方的持续流行及其与健康社会决定因素的关系。观察到社会经济劣势更大（即ADI更高）的患者之间联合处方的关联更强，强调了将ADI纳入处方风险评估的重要性。
