Safety of benzodiazepines and opioids in interstitial lung disease: a national prospective study.

Abstract

Safety concerns are a barrier to prescribing benzodiazepines (BDZs) and opioids in interstitial lung disease (ILD). We therefore examined the association of BDZs and opioids on risk of admission to hospital and death.We conducted a population-based longitudinal cohort study of fibrotic ILD patients starting long-term oxygen therapy in Sweden between October 2005 and December 2014. Effects of BDZs and opioids on rates of admission to hospital and mortality were analysed using Fine-Gray and Cox regression while adjusting for potential confounders.We included 1603 patients (61% females). BDZs were used by 196 (12%) patients and opioids were used by 254 (15%) patients. There was no association between BDZs and increased admission. Treatment with high- versus low-dose BDZs was associated with increased mortality (subdistribution hazard ratio (SHR) 1.46, 95% CI 1.08-1.98 versus 1.13, 95% CI 0.92-1.38). Opioids showed no association with increased admission. Neither low-dose opioids (≤30 mg·day-1 oral morphine equivalent) (SHR 1.18, 95% CI 0.96-1.45) nor high-dose opioids (>30 mg·day-1 oral morphine equivalent) (SHR 1.11, 95% CI 0.89-1.39) showed association with increased mortality.This first ever study to examine associations between BDZ and opioid use and harm in ILD supports the use of opioids and low-dose BDZs in severely ill patients with respiratory compromise.

• Authors: Sabrina Bajwah, Joanna M Davies, Hanan Tanash, David C Currow, Adejoke O Oluyase, Magnus Ekström
• Journal: The European respiratory journal (Eur Respir J) Vol. 52 Issue 6 (12 2018) ISSN: 1399-3003 [Electronic] England
• PMID: 30309973 (Publication Type: Journal Article)
• Copyright: Copyright ©ERS 2018.

Chemical References

• Analgesics, Opioid
• Benzodiazepines

Topics

• Aged
• Aged, 80 and over
• Analgesics, Opioid (adverse effects, therapeutic use)
• Benzodiazepines (adverse effects, therapeutic use)
• Female
• Hospitalization (statistics & numerical data)
• Humans
• Longitudinal Studies
• Lung Diseases, Interstitial (mortality, therapy)
• Male
• Outcome Assessment, Health Care
• Oxygen Inhalation Therapy
• Proportional Hazards Models
• Prospective Studies
• Sweden (epidemiology)