Risultati per: Benzodiazepine a lunga durata di azione

Ricerca di team Università, prevenzione con test su 120 bambini

Objective
To investigate the association between opioid replacement therapy (ORT) and benzodiazepine (BZD) coprescription and all-cause mortality compared with the prescription of ORT alone.

Design
Population-based cohort study.

Setting
Scotland, UK.

Participants
Participants were people prescribed ORT between January 2010 and end of December 2020 aged 18 years or above.

Main outcome measures
All-cause mortality, drug-related deaths and non-drug related deaths.

Secondary outcome
ORT continuous treatment duration.

Analysis
Cox regression with time-varying covariates.

Results
During follow-up, 5776 of 46 899 participants died: 1398 while on coprescription and 4378 while on ORT only. The mortality per 100 person years was 3.11 during coprescription and 2.34 on ORT only. The adjusted HR for all-cause mortality was 1.17 (1.10 to 1.24). The adjusted HR for drug-related death was 1.14 (95% CI, 1.04 to 1.24) and the hazard for death not classified as drug-related was 1.19 (95% CI, 1.09 to 1.30).

Conclusion
Coprescription of BZDs in ORT was associated with an increased risk of all-cause mortality, although with a small effect size than the international literature. Coprescribing was also associated with longer retention in treatment. Risk from BZD coprescription needs to be balanced against the risk from illicit BZDs and unplanned treatment discontinuation. A randomised controlled trial is urgently needed to provide a clear clinical direction.

Trial registration number
NCT04622995.

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«Quello che ad un occhio poco attento potrebbe sembrare un semplice accorgimento tecnico – sostiene Silvestro Scotti, segretario generale Fimmg – è invece un intervento legislativo che valorizza migliaia di professionisti (si stima più di 7.000 medici di medicina generale) e avrà un impatto positivo su milioni di cittadini»

Objectives
The aim of this study was to investigate physician benzodiazepine (BZD) self-use pre-COVID-19 pandemic and to examine changes in BZD self-use during the first year of the pandemic.

Design
Population-based retrospective cohort study using linked routinely collected administrative health data comparing the first year of the pandemic to the period before the pandemic.

Setting
Province of Ontario, Canada between March 2016 and March 2021.

Participants

Intervention
Onset of the COVID-19 pandemic in March 2020.

Outcomes measures
The primary outcome measure was the receipt of one or more prescriptions for BZD, which was captured via the Narcotics Monitoring System.

Results
In a cohort of 30 798 physicians (mean age 42, 47.8% women), we found that during the year before the pandemic, 4.4% of physicians had 1 or more BZD prescriptions. Older physicians (6.8% aged 50+ years), female physicians (5.1%) and physicians with a prior mental health (MH) diagnosis (12.4%) were more likely than younger (3.7% aged

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This Viewpoint discusses complex persistent benzodiazepine dependence and differentiates it from benzodiazepine use disorder.

Objectives
Although chiropractic spinal manipulative therapy (CSMT) and prescription benzodiazepines are common treatments for radicular low back pain (rLBP), no research has examined the relationship between these interventions. We hypothesise that utilisation of CSMT for newly diagnosed rLBP is associated with reduced odds of benzodiazepine prescription through 12 months’ follow-up.

Design
Retrospective cohort study.

Setting
National, multicentre 73-million-patient electronic health records-based network (TriNetX) in the USA, queried on 30 July 2021, yielding data from 2003 to the date of query.

Participants
Adults aged 18–49 with an index diagnosis of rLBP were included. Serious aetiologies of low back pain, structural deformities, alternative neurological lesions and absolute benzodiazepine contraindications were excluded. Patients were assigned to cohorts according to CSMT receipt or absence. Propensity score matching was used to control for covariates that could influence the likelihood of benzodiazepine utilisation.

Outcome measures
The number, percentage and OR of patients receiving a benzodiazepine prescription over 3, 6 and 12 months’ follow-up prematching and postmatching.

Results
After matching, there were 9206 patients (mean (SD) age, 37.6 (8.3) years, 54% male) per cohort. Odds of receiving a benzodiazepine prescription were significantly lower in the CSMT cohort over all follow-up windows prematching and postmatching (p