Indications and patterns of use of benzodiazepines and opioids in severe interstitial lung disease: a population-based longitudinal study.

Genberg, J; Davies, JM; Ahmadi, Z; Currow, D; Johnson, MJ; Tanash, H; Bajwah, S; Ekström, M

Indications and patterns of use of benzodiazepines and opioids in severe interstitial lung disease: a population-based longitudinal study.

Genberg, J Davies, JM Ahmadi, Z Currow, D

Johnson, MJ Tanash, H Bajwah, S Ekström, M

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Publisher:: European Respiratory Society (ERS)
Publication Type:: Journal Article
Citation:: ERJ open research, 2021, 7, (1), pp. 00716-2020
Issue Date:: 2021-01

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Field	Value	Language
dc.contributor.author	Genberg, J
dc.contributor.author	Davies, JM
dc.contributor.author	Ahmadi, Z
dc.contributor.author	Currow, D https://orcid.org/0000-0003-1988-1250
dc.contributor.author	Johnson, MJ
dc.contributor.author	Tanash, H
dc.contributor.author	Bajwah, S
dc.contributor.author	Ekström, M
dc.date.accessioned	2021-02-26T19:33:54Z
dc.date.available	2020-12-04
dc.date.available	2021-02-26T19:33:54Z
dc.date.issued	2021-01
dc.identifier.citation	ERJ open research, 2021, 7, (1), pp. 00716-2020
dc.identifier.issn	2312-0541
dc.identifier.issn	2312-0541
dc.identifier.uri	http://hdl.handle.net/10453/146495
dc.description.abstract	<h4>Background</h4>Despite evidence that opioids might relieve chronic breathlessness, physicians may still be reluctant to prescribe them due to safety concerns. By contrast, benzodiazepine (BDZ) prescribing often seeks to reduce chronic breathlessness despite no evidence of net benefit. Prescribing patterns and indications for these medications in severe interstitial lung disease (ILD) are unknown. Here, our objective was to evaluate the indications, medications and temporal patterns of BDZ and opioid prescriptions in people with oxygen-dependent ILD.<h4>Methods</h4>This was an observational, population-based, longitudinal study of adults starting long-term oxygen therapy (LTOT) for ILD between 2005 and 2014 in the Swedish National Registry for Respiratory Failure (Swedevox). People dispensed BDZs (n=2000) and opioids (n=2000) from 6 months before start of LTOT throughout follow-up (first of death or study end) were analysed.<h4>Results</h4>Of 1635 included patients, 651 (39.8%) received BDZs and 710 (43.4%) received opioids during the study period; 373 (22.8%) patients received both. The most frequently prescribed BDZs and opioids were oxazepam (85.6%) and oxycodone (28.7%), respectively. Indications for breathlessness were uncommon for BDZs (1.4%) and opioids (6.4%). During the last year of life, opioid indications for breathlessness increased from 2.5% (12-10 months before death) to 10.2% in the last 3 months of life (p=0.048).<h4>Conclusions</h4>In oxygen-dependent ILD, opioids are rarely prescribed for breathlessness even in the last months of life, when chronic breathlessness often increases in prevalence and intensity.
dc.format	Electronic-eCollection
dc.language	eng
dc.publisher	European Respiratory Society (ERS)
dc.relation.ispartof	ERJ open research
dc.relation.isbasedon	10.1183/23120541.00716-2020
dc.rights	info:eu-repo/semantics/openAccess
dc.title	Indications and patterns of use of benzodiazepines and opioids in severe interstitial lung disease: a population-based longitudinal study.
dc.type	Journal Article
utslib.citation.volume	7
utslib.location.activity	England
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
pubs.organisational-group	/University of Technology Sydney
utslib.copyright.status	open_access	*
dc.date.updated	2021-02-26T19:33:52Z
pubs.issue	1
pubs.publication-status	Published
pubs.volume	7
utslib.citation.issue	1

Abstract:

Background

Despite evidence that opioids might relieve chronic breathlessness, physicians may still be reluctant to prescribe them due to safety concerns. By contrast, benzodiazepine (BDZ) prescribing often seeks to reduce chronic breathlessness despite no evidence of net benefit. Prescribing patterns and indications for these medications in severe interstitial lung disease (ILD) are unknown. Here, our objective was to evaluate the indications, medications and temporal patterns of BDZ and opioid prescriptions in people with oxygen-dependent ILD.

Methods

This was an observational, population-based, longitudinal study of adults starting long-term oxygen therapy (LTOT) for ILD between 2005 and 2014 in the Swedish National Registry for Respiratory Failure (Swedevox). People dispensed BDZs (n=2000) and opioids (n=2000) from 6 months before start of LTOT throughout follow-up (first of death or study end) were analysed.

Results

Of 1635 included patients, 651 (39.8%) received BDZs and 710 (43.4%) received opioids during the study period; 373 (22.8%) patients received both. The most frequently prescribed BDZs and opioids were oxazepam (85.6%) and oxycodone (28.7%), respectively. Indications for breathlessness were uncommon for BDZs (1.4%) and opioids (6.4%). During the last year of life, opioid indications for breathlessness increased from 2.5% (12-10 months before death) to 10.2% in the last 3 months of life (p=0.048).

Conclusions

In oxygen-dependent ILD, opioids are rarely prescribed for breathlessness even in the last months of life, when chronic breathlessness often increases in prevalence and intensity.

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http://hdl.handle.net/10453/146495