{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T15:24:53Z","timestamp":1790436293314,"version":"4.1.0"},"reference-count":29,"publisher":"BMJ","issue":"1","funder":[{"DOI":"10.13039\/100007217","name":"Health Services Research and Development","doi-asserted-by":"publisher","award":["1IK2HX000775"],"award-info":[{"award-number":["1IK2HX000775"]}],"id":[{"id":"10.13039\/100007217","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000009","name":"Foundation for the National Institutes of Health","doi-asserted-by":"publisher","award":["RO1 MD12565 and R01 CA12008"],"award-info":[{"award-number":["RO1 MD12565 and R01 CA12008"]}],"id":[{"id":"10.13039\/100000009","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Gastroenterol"],"accepted":{"date-parts":[[2019,2,23]]},"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Data on patterns and correlates of opioid and benzodiazepines prescriptions among patients with chronic conditions are limited. Given a diminished capacity for hepatic clearance, patients with cirrhosis represent a high risk group for use. The aim of this study was to characterise the patterns and correlates of prescription opioid, benzodiazepine and dual drug prescriptions among individuals with common chronic diseases.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Analysis of Truven Marketscan database to evaluate individuals with drug coverage with cirrhosis (n=169,181), chronic hepatitis C without cirrhosis (n=210 191), congestive heart failure (n=766 840) or chronic obstructive pulmonary disease (n=1 438 798). Pharmacy files were examined for outpatient prescriptions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Patients with cirrhosis had a significantly higher prevalence of opioid prescriptions (37.1 per 100 person-years vs 24.3\u201326.0, p\u22640.001) and benzodiazepine prescriptions (21.3 per 100 person-years vs 12.1\u201312.9, p&lt;0.001). High dose opioid prescription (<jats:underline>&gt;<\/jats:underline>90 daily oral morphine equivalents) (29.1% vs 14.4%, p&lt;0.001) and dual opioid and benzodiazepine prescription (17.5% vs 9.6%\u201310.5 %, p&lt;0.001) were also significantly more prevalent in cirrhosis. High dose opioid prescription was greater in men, individuals ages 40\u201359, in the Western USA, and among those with a mental health or substance abuse condition. Dual opioid and benzodiazepine prescription were highest among those with alcoholic cirrhosis and middle aged-adults.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Persons with cirrhosis have significantly higher rates of prescription opioid and benzodiazepine prescription compared to others with chronic diseases despite their high risk for adverse drug reactions. Demographics and mental health or substance abuse history can help identify high risk groups to target interventions.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjgast-2018-000271","type":"journal-article","created":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T04:52:05Z","timestamp":1685508725000},"page":"e000271","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Opioid and benzodiazepine prescription among patients with cirrhosis compared to other forms of chronic disease"],"prefix":"10.1136","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8381-6149","authenticated-orcid":false,"given":"Monica A","family":"Konerman","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of Michigan Hospital, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Rogers","sequence":"additional","affiliation":[{"name":"University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brooke","family":"Kenney","sequence":"additional","affiliation":[{"name":"University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit G","family":"Singal","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Texas Southwestern, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0839-1515","authenticated-orcid":false,"given":"Elliot","family":"Tapper","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Michigan Hospital, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratima","family":"Sharma","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameer","family":"Saini","sequence":"additional","affiliation":[{"name":"University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brahmajee","family":"Nallamothu","sequence":"additional","affiliation":[{"name":"VA Center for Clinical Management Research, VA Ann Arbor Health Care System, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akbar","family":"Waljee","sequence":"additional","affiliation":[{"name":"University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,4,14]]},"reference":[{"key":"2025073013270694000_6.1.e000271.1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6626a4"},{"key":"2025073013270694000_6.1.e000271.2","unstructured":"United States Department of Health and Human Services . 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