ArticleBMJ open2021
Association of co-prescribing of opioid and benzodiazepine substitutes with incident falls and fractures among older adults: a cohort study.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
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Who cites it
18 citing papers in PubMed, 23 citations in OpenAlex.
- Factors associated with prolonged use of newly prescribed gabapentinoids in older adults undergoing colorectal surgery.Perioperative medicine (London, England) · 2026Article
- Factors Associated With Concurrent Benzodiazepine and Opioid Use Following Total Hip and Knee Arthroplasty: A Nationwide Cohort Study.Pharmacoepidemiology and drug safety · 2026Article
- Association of benzodiazepine and opioid use with hip fracture treated with arthroplasty: a nationwide case-control study.BMC geriatrics · 2026Article
- 10-year trends in benzodiazepine, opioid, and concurrent use in hip and knee arthroplasty: a nationwide cohort study from the Netherlands.Acta orthopaedica · 2025Article
- Patterns of Benzodiazepines and Hypnotic Drugs Dispensing After Hip Fracture Among Older US Adults Previously on the Drugs.Journal of the American Geriatrics Society · 2025Article
- Benzodiazepine Initiation and the Risk of Falls or Fall-Related Injuries in Older Adults Following Acute Ischemic Stroke.Neurology. Clinical practice · 2025Article
- Rates and predictors of opioid deprescribing after fracture: A retrospective study of Medicare fee-for-service claims.Journal of the American Geriatrics Society · 2025Article
- Article
- Gabapentinoid use and the risk of fractures in patients with inflammatory arthritis: nested case-control study in the Clinical Practice Research Datalink Aurum.BMC medicine · 2024Article
- Patterns of gabapentinoid use among long-term opioid users.Preventive medicine · 2024Article
- Review
- Validating claims-based definitions for deprescribing: Bridging the gap between clinical and administrative data.Pharmacoepidemiology and drug safety · 2024Article
- Signal detection of adverse events associated with gabapentinoid use for chronic pain.Pharmacoepidemiology and drug safety · 2024Article
- Defensive and Emotional Behavior Modulation by Serotonin in the Periaqueductal Gray.Cellular and molecular neurobiology · 2023Review
- Recurrent Falls over Three Years among Older Adults Age 70+: Associations with Physical and Mental Health Status, Exercise, and Hospital Stay.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2023Article
- Gabapentin utilization among older adults with different cognitive statuses enrolled in the National Alzheimer's Coordinating Center (2006-2019).British journal of clinical pharmacology · 2023Article
- Trends in the Use of Opioids vs Nonpharmacologic Treatments in Adults With Pain, 2011-2019.JAMA network open · 2022Article
- Incident Functional Limitations Among Community-Dwelling Adults Using Opioids: A Retrospective Cohort Study Using a Propensity Analysis with the Health and Retirement Study.Drugs & aging · 2022Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveExamine the association between the co-prescribing of opioids, benzodiazepines, gabapentinoids (pregabalin and gabapentin) and selective serotonin reuptake inhibitors/serotonin and norepinephrine reuptake inhibitors (SSRI/SNRIs) in different combinations and the risk of falls and fractures.
designRetrospective cohort study from 2015 to 2018.
settingMedicare enrolment and claims data.
participantsMedicare beneficiaries with both chronic pain and anxiety disorders in 2016 with continuous enrolments in Parts A and B from 2015 to 2016 who were prescribed any combination of opioid, benzodiazepine, gabapentinoid and SSRI/SNRI in 2017 for ≥7 days, as documented in their Medicare Part D coverage.
interventionsAny combination of use of seven drug regimens (benzodiazepine +opioid; benzodiazepine +gabapentinoid; benzodiazepine +SSRI/SNRI; opioid +gabapentinoid; opioid +SSRI/SNRI; gabapentinoid +SSRI/SNRI; ≥3 drug classes). MAIN OUTCOMES: First event of fall and the first event of fracture after the index date, which was the first day of combination drug use that lasted ≥7 days in 2017.
resultsA total of 47 964 patients (mean [SD] age, 75.9 [7.1]; 78.0% woman) with diagnoses of both chronic pain and anxiety were studied. The median (Q1-Q3) duration of drug combination use was 26 (14-30) days. After adjusting for demographic characteristics, chronic conditions and history of hospitalisation and fall or fracture, the co-prescribing of ≥3 drugs (adjusted HR [aHR], 1.38; 95% CI 1.14 to 1.67) and opioid plus gabapentinoid (aHR, 1.18; 95% CI 1.02 to 1.37) were associated with a high fall risk, compared with benzodiazepineplus opioid co-prescribing, findings consistent with the secondary analysis using inverse probability of treatment weighting with propensity scores. The co-prescribing of benzodiazepine plus gabapentinoid (aHR, 0.76; 95% CI 0.59 to 0.98) was associated with lower fracture risk compared with the co-prescribing of benzodiazepine plus opioid, though this finding was not robust.
conclusionsOur findings add to comparative toxicity research on different combinations of gabapentinoids and serotonergic agents commonly prescribed with or as substitutes for opioids and benzodiazepines in patients with co-occurring chronic pain and anxiety.
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