{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T21:27:15Z","timestamp":1791581235030,"version":"4.3.4"},"reference-count":49,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T00:00:00Z","timestamp":1679356800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["PJT 168914"],"award-info":[{"award-number":["PJT 168914"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012665","name":"Institute for Clinical Evaluative Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012665","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A concern with long\u2010term opioid use is the increased risk arising when opioids are used concurrently with drugs that can potentiate their associated adverse effects. The drugs most often encountered are benzodiazepines (BZDs) and gabapentinoids. Our study objectives were to examine trends in the concurrent use of opioids and BZDs, or gabapentinoids, in a Canadian nursing home population over an 11\u2010year period, and current resident\u2010level correlates of this concurrent use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a population\u2010based, repeated cross\u2010sectional study among Ontario nursing home residents (&gt;65\u2009years) dispensed opioids between April 2009 and February 2020. For the last study year, we examined cross\u2010sectional associations between resident characteristics and concurrent use of opioids with BZDs or gabapentinoids. Linked data on nursing home residents from clinical and health administrative databases was used. The yearly proportions of residents who were dispensed an opioid concurrently with a BZD or gabapentinoid were plotted with percent change derived from log\u2010binomial regression models. Separate modified Poisson regression models estimated resident\u2010level correlates of concurrent use of opioids with BZDs or gabapentinoids.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over the study period, among residents dispensed an opioid there was a 53.2% relative decrease (30.7% to 14.4%) in concurrent BZD and a 505.4% relative increase (4.4% to 26.6%) in concurrent gabapentinoid use. In adjusted models, increasing age and worsening cognition were inversely associated with the concurrent use of both classes, but most other significantly related covariates were unique to each drug class (e.g., sex and anxiety disorders for BZD, pain severity and presence of pain\u2010related conditions for gabapentinoids).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Co\u2010administration of BZDs or gabapentinoids in Ontario nursing home residents dispensed opioids remains common, but the pattern of co\u2010use has changed over time. Observed covariates of concurrent use in 2019\/20 suggest distinct but overlapping resident populations requiring consideration of the relative risks versus benefits of this co\u2010use and monitoring for potential harm.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.18320","type":"journal-article","created":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T09:12:55Z","timestamp":1679389975000},"page":"2462-2475","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Trends and correlates of concurrent opioid and benzodiazepine and\/or gabapentinoid use among Ontario nursing home residents"],"prefix":"10.1111","volume":"71","author":[{"given":"David B.","family":"Hogan","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Geriatric Medicine, Cumming School of Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Campitelli","sequence":"additional","affiliation":[{"name":"ICES  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7341-0655","authenticated-orcid":false,"given":"Susan E.","family":"Bronskill","sequence":"additional","affiliation":[{"name":"ICES  Toronto Ontario Canada"},{"name":"Institute of Health Policy, Management &amp; Evaluation University of Toronto  Toronto Ontario Canada"},{"name":"Sunnybrook Health Sciences Centre Sunnybrook Research Institute  Toronto Ontario Canada"},{"name":"Women's College Research Institute Women's College Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4268-6832","authenticated-orcid":false,"given":"Andrea","family":"Iaboni","sequence":"additional","affiliation":[{"name":"Toronto Rehabilitation Institute University Health Network  Toronto Ontario Canada"},{"name":"Department of Psychiatry University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather E.","family":"Barry","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Primary Care Research Group Queen's University Belfast  Belfast UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmel M.","family":"Hughes","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Primary Care Research Group Queen's University Belfast  Belfast UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudeep S.","family":"Gill","sequence":"additional","affiliation":[{"name":"ICES  Toronto Ontario Canada"},{"name":"Department of Medicine Queen's University  Kingston Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7988-2899","authenticated-orcid":false,"given":"Colleen J.","family":"Maxwell","sequence":"additional","affiliation":[{"name":"ICES  Toronto Ontario Canada"},{"name":"School of Pharmacy University of Waterloo  Waterloo Ontario Canada"},{"name":"School of Public Health Sciences University of Waterloo  Waterloo Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,21]]},"reference":[{"issue":"11","key":"e_1_2_12_2_1","first-page":"1269","article-title":"Canadian guideline for safe and effective use of opioids for chronic noncancer pain: clinical summary for family physicians. Part 2: special populations","volume":"57","author":"Kahan M","year":"2011","journal-title":"Can Fam Phys"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.1464"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3928\/00989134-20190813-02"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40266-021-00836-8"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20190052"},{"key":"e_1_2_12_7_1","unstructured":"StevensonD ChengA HuskampH.Opioid Use in Long\u2010Term Care Settings: Final Report. Office of Behavioral Health Disability and Aging Policy (US Department of Health and Human Services Washington DC).2022https:\/\/aspe.hhs.gov\/sites\/default\/files\/documents\/68687c9e1d32acf7e6b63d1255c307b0\/ltc\u2010settings\u2010opioid\u2010use.pdf. Accessed October 9 2022"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2020.09.007"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-200007000-00035"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.4103\/jpp.JPP_56_18"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.3810\/pgm.2013.07.2684"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000913"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002396"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.7326\/M18-1136"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1041610217002745"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003921"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2021.08.024"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40266-021-00872-4"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2021.12.043"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17709"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S221579"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40266-022-00972-9"},{"key":"e_1_2_12_23_1","volume-title":"Health Canada Advises Canadians to Exercise Caution When Taking Gabapentin or Pregabalin with Opioids","year":"2019"},{"key":"e_1_2_12_24_1","volume-title":"FDA Warns About Serious Breathing Problems with Seizure and Nerve Pain Medicines Gabapentin (Neurontin, Gralise, Horizant) and Pregabalin (Lyrica, Lyrica CR)","year":"2019"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.18441"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2022.02.011"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16710"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6947-13-27"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/50A.2.M128"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/29.2.165"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2008.02048.x"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/54.11.M546"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15016"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-021-03244-4"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000002525"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1089\/pop.2019.0128"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15767"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.3697"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh090"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1177\/0962280211427759"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.31027\/ODPRN.2021.01"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.13659"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1177\/1178221818801311"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.180599"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2018.04.005"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-14-S1-S1"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2019.112671"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnw351"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-030858"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1503\/jpn.180051"}],"container-title":["Journal of the American Geriatrics Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.18320","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jgs.18320","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.18320","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T15:45:59Z","timestamp":1762184759000},"score":1,"resource":{"primary":{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/10.1111\/jgs.18320"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,21]]},"references-count":49,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1111\/jgs.18320"],"URL":"https:\/\/doi.org\/10.1111\/jgs.18320","archive":["Portico"],"relation":{},"ISSN":["0002-8614","1532-5415"],"issn-type":[{"value":"0002-8614","type":"print"},{"value":"1532-5415","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,21]]},"assertion":[{"value":"2022-11-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}