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WEDNESDAY, May 27, 2020 (HealthDay News) — Patients initiating hemodialysis often are prescribed opioids and short-acting benzodiazepines, which are associated with increased mortality risk, according to a study published online May 26 in the Clinical Journal of the American Society of Nephrology<\/i>.<\/p>\n
Abimereki D. Muzaale, M.D., M.P.H., from the Johns Hopkins University School of Medicine in Baltimore, and colleagues examined the mortality risk associated with short- and long-acting benzodiazepines and their interaction with opioids in a cohort of 69,368 adults initiating hemodialysis.<\/p>\n
Sixteen and 5 percent of patients were dispensed a short- and long-acting benzodiazepine, respectively, within one year of hemodialysis initiation. The researchers found that codispensing of opioids and short- and long-acting benzodiazepines occurred among 26 and 8 percent, respectively, of those dispensed a benzodiazepine during follow-up. Patients with an opioid prescription were more likely to be subsequently dispensed a short- and long-acting benzodiazepine (adjusted hazard ratios, 1.66 and 1.11, respectively). Compared with those without a short-acting benzodiazepine, those dispensed a short-acting benzodiazepine had a 1.45-fold increased mortality risk; this risk was increased 1.90-fold among those with opioid codispensing. There was an inverse association for long-acting benzodiazepines with mortality (adjusted hazard ratio, 0.84); no differential risk was seen by opioid dispensing.<\/p>\n
“Providers caring for patients undergoing hemodialysis should be given the tools needed to implement a collaborative, team-based approach for deprescribing of short-acting benzodiazepines, particularly for patients who are likely to use opioids,” the authors write.<\/p>\n
One author disclosed financial ties to the pharmaceutical industry.<\/p>\n
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