Evidence map›Paper›PMID 32334602›Full record

ArticleBMC health services research2020

Dispensations of benzodiazepines, z-hypnotics, and gabapentinoids to patients receiving opioid agonist therapy; a prospective cohort study in Norway from 2013 to 2017.

Jørn Henrik Vold, Svetlana Skurtveit, Christer Aas, Fatemeh Chalabianloo, Pia Synnøve Kloster, Kjell Arne Johansson, Lars Thore Fadnes

Open access · goldAbstract read
In one paragraph

Article in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
2.9field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 21 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Jørn Henrik VoldDepartment of Addiction Medicine, Haukeland University Hospital, Bergen, Norway. jorn.vold@uib.no.
Svetlana SkurtveitDepartment of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway.
Christer AasDepartment of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.
Fatemeh ChalabianlooDepartment of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.
Pia Synnøve KlosterDepartment of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.
Kjell Arne JohanssonDepartment of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.
Lars Thore FadnesDepartment of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.
Haukeland University Hospital · NOUniversity of Bergen · NOUniversity of Oslo · NO

Funding

Norges Forskningsråd 269855
6 · The paper itself

Abstract

backgroundDispensations of benzodiazepines, z-hypnotics, and gabapentinoids to patients on opioid agonist therapy (OAT) are common and have pros and cons. The objectives of the current study are to define the dispensation rates of these potentially addictive drugs, and whether the number and the mean daily doses of dispensed OAT opioids and discontinuing OAT, are associated with being dispensed benzodiazepines, z-hypnotics and gabapentinoids among patients on OAT in Norway in the period 2013 to 2017.

methodsInformation about all dispensed opioids, benzodiazepines, z-hypnotics and gabapentinoids were recorded from the Norwegian Prescription Database (NorPD). A total of 10,371 OAT patients were included in the study period. The dispensation rates were defined as the number of patients who were dispensed at least one of the potentially addictive drugs divided among the number of patients who have dispensed an OAT opioid per calendar year. Mean daily doses were calculated, and for benzodiazepines and z-hypnotics, stated in diazepam equivalents. The association between dispensed potentially addictive drugs, and the number and the type of dispensed OAT opioids were calculated by using logistic regression models.

resultsHalf of the OAT patients received at least one dispensation of a benzodiazepine or z-hypnotic, and 11% were dispensed at least a gabapentinoid in 2017. For dispensed benzodiazepines or z-hypnotics, the mean daily dose was reduced from 21 mg (95% confidence interval (CI): 20-23) diazepam equivalents in 2013 to 17 mg (95% CI: 16-17) in 2017. The mean daily dose of pregabalin increased from 365 mg (95% CI: 309-421) in 2013 to 386 mg (95% CI: 349-423) in 2017. Being dispensed a gabapentinoid (adjusted odds ratio (aOR) = 2.5, 95% CI: 2.1-3.0) or a non-OAT opioid (aOR = 3.0, 95% CI: 2.6-3.5) was associated with being dispensed a benzodiazepine or z-hypnotic. Discontinuing OAT did not affect the number of dispensations and the doses of potentially addictive drugs.

conclusionThe dispensation rates of potentially addictive drugs are high in the OAT population. Treatment indications, as well as requirements for prescription authority, need to be debated and made explicit. Randomized controlled trials evaluating the benefits and risks of such co-prescription are required.

Indexed as

AdultAnalgesics, OpioidBenzodiazepinesDatabases, FactualDrug PrescriptionsFemaleGabapentinHumansHypnotics and SedativesMaleMiddle AgedNorwayProspective StudiesAnalgesics, OpioidBenzodiazepinesGabapentinHypnotics and SedativesBenzodiazepinesDrug prescriptionsGabapentinOpioidsOpioid substitution treatmentPregabalinZolpidemZopiclone

Identifiers

PMID32334602
PMCPMC7183604
OpenAlexW3019904842

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.