PMID- 32333265 OWN - NLM STAT- MEDLINE DCOM- 20210702 LR - 20210702 IS - 1970-9366 (Electronic) IS - 1828-0447 (Linking) VI - 15 IP - 7 DP - 2020 Oct TI - Risk of hospitalisation associated with benzodiazepines and z-drugs in Italy: a nationwide multicentre study in emergency departments. PG - 1291-1302 LID - 10.1007/s11739-020-02339-7 [doi] AB - Benzodiazepines (BZD) and z-drugs (ZD) are a widely prescribed group of medicines. They are often used inappropriately, and this is associated with adverse events (AEs), which may cause emergency department (ED) visits. The present study aimed to describe the characteristics of BZD and ZD related AEs leading to emergency department (ED) visit and hospitalisation in Italy, considering their plasma half-life. Ninety-two Italian EDs were monitored between 2007 and 2018. Rates of ED visit and hospitalisation were calculated. Multivariate logistic regression was used to estimate the reporting odds ratios (RORs) of hospitalisation. Univariate linear regression was performed to evaluate the ROR of hospitalisation according the plasma half-life of the suspected agents. A total of 3203 AE reports were collected. Overall, multivariate logistic regression showed that the risk of hospitalisation was higher for prazepam (3.26 [1.31-8.11]), flurazepam (1.62 [1.15-2.27]), and lorazepam (1.36 [1.15-1.61]). In the elderly, this risk was higher for prazepam (3.98 [1.03-15.3]), and lorazepam (1.58 [1.19-2.11]). Parenteral and rectal formulations were associated with a lower risk of hospitalisation compared to oral formulations. Our findings underlined the dangers in the use of BZD and ZD in Italy, particularly in women and older adults. ED clinicians must always take into account that the higher risk in terms of hospitalisation related to the use of BZD and ZD can be observed in patients treated with oral formulations, in those exposed to more than one sedative-hypnotics, and in patients exposed to compounds with intermediate or long plasma half-life. FAU - Lombardi, Niccolo AU - Lombardi N AD - Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Viale G. Pieraccini, 6, 50139, Florence, Italy. FAU - Bettiol, Alessandra AU - Bettiol A AD - Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Viale G. Pieraccini, 6, 50139, Florence, Italy. FAU - Crescioli, Giada AU - Crescioli G AD - Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Viale G. Pieraccini, 6, 50139, Florence, Italy. FAU - Ravaldi, Claudia AU - Ravaldi C AD - Department of Health Sciences, University of Florence, 50139, Florence, Italy. FAU - Bonaiuti, Roberto AU - Bonaiuti R AD - Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Viale G. Pieraccini, 6, 50139, Florence, Italy. AD - Joint Laboratory of Technological Solutions for Clinical Pharmacology, Pharmacovigilance and Bioinformatics, University of Florence, 50139, Florence, Italy. FAU - Venegoni, Mauro AU - Venegoni M AD - Pharmacology Unit, Department of Diagnostics and Public Health, University of Verona, 37100, Verona, Italy. FAU - Vighi, Giuseppe Danilo AU - Vighi GD AD - Internal Medicine, Medical Department, Vimercate Hospital, ASST Di Vimercate, 20871, Vimercate, Italy. FAU - Mugelli, Alessandro AU - Mugelli A AD - Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Viale G. Pieraccini, 6, 50139, Florence, Italy. FAU - Mannaioni, Guido AU - Mannaioni G AD - Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Viale G. Pieraccini, 6, 50139, Florence, Italy. AD - Toxicology Unit and Poison Centre, Careggi University Hospital, Florence, Italy. FAU - Vannacci, Alfredo AU - Vannacci A AUID- ORCID: 0000-0001-5259-2026 AD - Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Viale G. Pieraccini, 6, 50139, Florence, Italy. alfredo.vannacci@unifi.it. AD - Joint Laboratory of Technological Solutions for Clinical Pharmacology, Pharmacovigilance and Bioinformatics, University of Florence, 50139, Florence, Italy. alfredo.vannacci@unifi.it. CN - MEREAFaPS Study group LA - eng GR - Tuscan County resolution DGRT 790/2016 All. C./Agenzia Italiana del Farmaco, Ministero della Salute/International PT - Journal Article PT - Multicenter Study DEP - 20200424 PL - Italy TA - Intern Emerg Med JT - Internal and emergency medicine JID - 101263418 RN - 0 (Hypnotics and Sedatives) RN - 12794-10-4 (Benzodiazepines) SB - IM CIN - Intern Emerg Med. 2021 Mar;16(2):521-523. PMID: 32875478 MH - Benzodiazepines/*adverse effects MH - *Emergency Service, Hospital MH - Female MH - Hospitalization/*statistics & numerical data MH - Humans MH - Hypnotics and Sedatives/*adverse effects MH - Italy/epidemiology MH - Male MH - Middle Aged MH - Pharmacovigilance MH - Prescription Drug Misuse/*statistics & numerical data MH - Retrospective Studies MH - Risk MH - Substance-Related Disorders/*epidemiology OTO - NOTNLM OT - Adverse event OT - Benzodiazepines OT - Emergency department OT - Hospitalisation OT - Substance abuse OT - z-drugs EDAT- 2020/04/26 06:00 MHDA- 2021/07/03 06:00 CRDT- 2020/04/26 06:00 PHST- 2019/10/17 00:00 [received] PHST- 2020/04/06 00:00 [accepted] PHST- 2020/04/26 06:00 [pubmed] PHST- 2021/07/03 06:00 [medline] PHST- 2020/04/26 06:00 [entrez] AID - 10.1007/s11739-020-02339-7 [pii] AID - 10.1007/s11739-020-02339-7 [doi] PST - ppublish SO - Intern Emerg Med. 2020 Oct;15(7):1291-1302. doi: 10.1007/s11739-020-02339-7. Epub 2020 Apr 24.