{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T15:03:16Z","timestamp":1789657396097,"version":"4.0.1"},"reference-count":53,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Concurrent use of benzodiazepines and opioids is discouraged due to synergistic adverse effects. However, patients undergoing total hip or knee arthroplasty (THA\/TKA) often receive them, particularly in the first 3 postoperative months. We identified factors associated with new outpatient concurrent benzodiazepine\u2010opioid dispensation following THA\/TKA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this nationwide cohort study, we linked the Dutch Arthroplasty Register with the Dutch Foundation for Pharmaceutical Statistics, which provided medication dispensation data. We included all patients undergoing primary elective THA\/TKA (2013\u20132022) who had no preoperative concurrent use in the 6\u2009months pre\u2010procedure. The primary outcome was \u2265\u20097\u2009days of a new concurrent benzodiazepine\u2010opioid dispensation within 90\u2010day postoperative. Determinants included patient and implant characteristics, and preoperative medication use. Multivariable logistic regression analyses were performed, adjusted for age, sex, and comorbidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 89\u2009139 THA and 76\u2009710 TKA patients, 3756 (4%) and 5571 (7%), respectively, received new postoperative concurrent benzodiazepine\u2010opioid dispensation within 90\u2010days postoperative. The main factor associated with such dispensation was preoperative benzodiazepine use (THA: OR 23.5 [95% CI: 21.8\u201325.3], TKA: OR 22.8 [95% CI: 21.3\u201324.3]), followed by preoperative antidepressant\/anxiolytic use (THA: OR 2.9 [95% CI: 2.6\u20133.1], TKA: OR 2.5 [95% CI: 2.3\u20132.7]). Other factors included female sex, current smoking, and American Society of Anesthesiologists (ASA) scale III\u2010IV. Preoperative pain scores, preoperative opioid use, and implant characteristics showed little to no association with the outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Preoperative benzodiazepine use was the main factor associated with new outpatient concurrent benzodiazepine\u2010opioid dispensation after THA\/TKA, followed by preoperative antidepressant\/anxiolytic use. These results highlighted that careful review of the patient's medication history when planning postoperative pain management could help prevent unsafe co\u2010prescription.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pds.70368","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T09:27:47Z","timestamp":1775813267000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors Associated With Concurrent Benzodiazepine and Opioid Use Following Total Hip and Knee Arthroplasty: A Nationwide Cohort Study"],"prefix":"10.1002","volume":"35","author":[{"given":"Manuela","family":"Yepes\u2010Calder\u00f3n","sequence":"first","affiliation":[{"name":"Department of Orthopedics Leiden University Medical Center  Leiden the Netherlands"},{"name":"Department of Clinical Epidemiology Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob G. 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H.","family":"Nelissen","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Leiden University Medical Center  Leiden the Netherlands"},{"name":"Dutch Arthroplasty Register (LROI), 's\u2010Hertogenbosch  the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel L.","family":"Bouvy","sequence":"additional","affiliation":[{"name":"Utrecht Institute for Pharmaceutical Sciences (UIPS), Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liza N.","family":"van Steenbergen","sequence":"additional","affiliation":[{"name":"Dutch Arthroplasty Register (LROI), 's\u2010Hertogenbosch  the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Dahan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frits R.","family":"Rosendaal","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maaike G. 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