PMID- 35732964
OWN - NLM
STAT- MEDLINE
DCOM- 20220812
LR  - 20221005
IS  - 1432-1041 (Electronic)
IS  - 0031-6970 (Print)
IS  - 0031-6970 (Linking)
VI  - 78
IP  - 9
DP  - 2022 Sep
TI  - Hospitalisations related to benzodiazepine, Z-drug, and opioid treatment in 
      Italy: a claim on the risks associated with inappropriate use.
PG  - 1511-1519
LID - 10.1007/s00228-022-03354-7 [doi]
AB  - PURPOSE: Benzodiazepines (BZD), Z-drugs (ZD), and opioids share a high risk of 
      abuse. This study assessed and characterised adverse events (AEs) related to BDZ, 
      ZD, and opioids leading to emergency department (ED) visits in the Italian 
      setting. METHODS: ED accesses related to BDZ, ZD, and/or opioids were analysed 
      from the MEREAFaPS database. Information on AEs, suspected and concomitant 
      medications was retrieved. Multivariate logistic regression was used to estimate 
      the reporting odds ratios (RORs) of hospitalisation according to the different 
      treatments. RESULTS: A total of 5,970 pharmacovigilance reports involving BZD/ZD 
      (n = 3,106), opioids (n = 2,767), or their combination (n = 97) were analysed. 
      Compared to opioids, patients with BZD/ZD-related AEs were often younger (51 vs 
      64 years), more frequently presented 2+ suspected medications (13 vs 3%), and 
      often had a history of abuse (4%). Twenty-three percent of BZD/ZD-related AEs 
      were related to drug abuse (vs 2% of opioid-related ones) and frequently required 
      patient hospitalisation (52% vs 24%), despite the significantly lower clinical 
      complexity of these patients as compared to those on opioids. An increased risk 
      of hospitalisation was found for flurazepam (ROR 1.62; 95% CI, 1.18-2.22), 
      prazepam (2.66; 1.05-6.70), lorazepam (1.26; 1.07-1.49), and morphine (1.76; 
      1.11-2.79). CONCLUSIONS: These results indicate that, in Italy, the inappropriate 
      use of BZD/ZD is a relevant heath issue, often leading to serious AEs requiring 
      patients' ED visits and hospitalisation, especially in young women and patients 
      with a history of substance abuse.
CI  - (c) 2022. The Author(s).
FAU - Mattioli, Irene
AU  - Mattioli I
AD  - Department of Experimental and Clinical Medicine, University of Florence, 
      Florence, Italy.
FAU - Bettiol, Alessandra
AU  - Bettiol A
AD  - Department of Experimental and Clinical Medicine, University of Florence, 
      Florence, Italy.
FAU - Crescioli, Giada
AU  - Crescioli G
AUID- ORCID: 0000-0002-1071-6120
AD  - Section of Pharmacology and Toxicology, Department of Neurosciences, Psychology, 
      Drug Research and Child Health, University of Florence, Viale G. Pieraccini, 6, 
      50139, Florence, Italy. giada.crescioli@unifi.it.
AD  - Tuscan Regional Centre of Pharmacovigilance, Florence, Italy. 
      giada.crescioli@unifi.it.
FAU - Bonaiuti, Roberto
AU  - Bonaiuti R
AD  - Section of Pharmacology and Toxicology, Department of Neurosciences, Psychology, 
      Drug Research and Child Health, University of Florence, Viale G. Pieraccini, 6, 
      50139, Florence, Italy.
FAU - Prisco, Domenico
AU  - Prisco D
AD  - Department of Experimental and Clinical Medicine, University of Florence, 
      Florence, Italy.
FAU - Mannaioni, Guido
AU  - Mannaioni G
AD  - Section of Pharmacology and Toxicology, Department of Neurosciences, Psychology, 
      Drug Research and Child Health, University of Florence, Viale G. Pieraccini, 6, 
      50139, Florence, Italy.
AD  - Medical Toxicology Unit and Poison Control Centre, Careggi University Hospital, 
      Florence, Italy.
FAU - Lombardi, Niccolo
AU  - Lombardi N
AD  - Section of Pharmacology and Toxicology, Department of Neurosciences, Psychology, 
      Drug Research and Child Health, University of Florence, Viale G. Pieraccini, 6, 
      50139, Florence, Italy.
AD  - Tuscan Regional Centre of Pharmacovigilance, Florence, Italy.
FAU - Vannacci, Alfredo
AU  - Vannacci A
AD  - Section of Pharmacology and Toxicology, Department of Neurosciences, Psychology, 
      Drug Research and Child Health, University of Florence, Viale G. Pieraccini, 6, 
      50139, Florence, Italy.
AD  - Tuscan Regional Centre of Pharmacovigilance, Florence, Italy.
CN  - MEREAFaPS Study group
LA  - eng
PT  - Journal Article
DEP - 20220622
PL  - Germany
TA  - Eur J Clin Pharmacol
JT  - European journal of clinical pharmacology
JID - 1256165
RN  - 0 (Analgesics, Opioid)
RN  - 12794-10-4 (Benzodiazepines)
SB  - IM
MH  - Analgesics, Opioid/adverse effects
MH  - *Benzodiazepines/adverse effects
MH  - Emergency Service, Hospital
MH  - Female
MH  - Hospitalization
MH  - Humans
MH  - *Substance-Related Disorders/drug therapy/epidemiology
PMC - PMC9365734
OTO - NOTNLM
OT  - Adverse drug reactions
OT  - Benzodiazepines
OT  - Drug safety
OT  - Opioids
OT  - Pharmacovigilance
OT  - Z-drugs
COIS- The authors declare no competing interests.
EDAT- 2022/06/23 06:00
MHDA- 2022/08/13 06:00
PMCR- 2022/06/22
CRDT- 2022/06/22 23:32
PHST- 2022/03/04 00:00 [received]
PHST- 2022/06/08 00:00 [accepted]
PHST- 2022/06/23 06:00 [pubmed]
PHST- 2022/08/13 06:00 [medline]
PHST- 2022/06/22 23:32 [entrez]
PHST- 2022/06/22 00:00 [pmc-release]
AID - 10.1007/s00228-022-03354-7 [pii]
AID - 3354 [pii]
AID - 10.1007/s00228-022-03354-7 [doi]
PST - ppublish
SO  - Eur J Clin Pharmacol. 2022 Sep;78(9):1511-1519. doi: 10.1007/s00228-022-03354-7. 
      Epub 2022 Jun 22.