{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T13:49:14Z","timestamp":1782913754748,"version":"3.54.5"},"reference-count":65,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2022,8,9]],"date-time":"2022-08-09T00:00:00Z","timestamp":1660003200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01DA039192"],"award-info":[{"award-number":["R01DA039192"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P30AG024832"],"award-info":[{"award-number":["P30AG024832"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Anxiety and chronic pain are common comorbidities in patients with chronic obstructive pulmonary disease (COPD), which are frequently managed with benzodiazepines (BZDs) and opioids, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The purpose of this study was to determine whether different combinations of opioids, BZD, and their substitutes\u2014gabapentinoids (GABA) and selective serotonin reuptake inhibitors\/serotonin-norepinephrine reuptake inhibitors (SSRIs\/SNRIs)\u2014are associated with lower risk of acute respiratory events in COPD patients with co-occurring chronic pain and anxiety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective cohort study used a nationally representative sample of Medicare beneficiaries with COPD, chronic pain, and anxiety. Patients were grouped based on drug combination (opioid + BZD\/Z-hypnotics, opioid + GABA, opioid + SSRI\/SNRI, BZD\/Z-hypnotics + GABA, BZD\/Z-hypnotics + SSRI\/SNRI, GABA + SSRI\/SNRI, or \u22653 drugs). The primary outcome was emergency room (ER) visit or hospitalization due to acute respiratory events assessed up to 180 days following initiation of drug combination. Overdose secondary to central nervous system (CNS)\u2013related drugs was also assessed up to 180 days following initiation of drug combination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The drug combination opioid + GABA was associated with decreased risk for ER visit (hazard ratio [HR] = 0.73; 95% CI = 0.61-0.87) and hospitalization (HR = 0.69; 95% CI = 0.55-0.85). Opioid + SSRI\/SNRI also showed decreased risk for ER visit (HR = 0.84; 95% CI = 0.71-0.99). There was no significant difference in risk for CNS-related drug overdose among different drug combinations compared with opioid + BZD\/Z-hypnotics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion and Relevance:<\/jats:title>\n                    <jats:p>Opioids in combination with GABA and SSRI\/SNRI demonstrate relatively lower risk for acute respiratory events among patients with COPD and comorbid chronic pain and anxiety. The findings emphasize the need for multimodal management in this vulnerable population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10600280221113299","type":"journal-article","created":{"date-parts":[[2022,8,9]],"date-time":"2022-08-09T03:01:56Z","timestamp":1660014116000},"page":"382-396","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Co-prescribing of Central Nervous System\u2013Active Medications for COPD Patients: Impact on Emergency Room Visits and Hospitalization"],"prefix":"10.1177","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6313-2738","authenticated-orcid":false,"given":"Akhil","family":"Sood","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong-Fang","family":"Kuo","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine &amp; Population Health, University of Texas Medical Branch, Galveston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan","family":"Westra","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine &amp; Population Health, University of Texas Medical Branch, Galveston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gulshan","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Pulmonary, Critical Care, &amp; Sleep Medicine, University of Texas Medical Branch, Galveston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7460-7281","authenticated-orcid":false,"given":"Mukaila A.","family":"Raji","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, University of Texas Medical Branch, Galveston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,8,9]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-83964-w."},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S271713."},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S275234."},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.15326\/jcopdf.4.3.2016.0172."},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare7010015."},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2009.126201."},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.2147\/CEOR.S80424."},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aen094."},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2012-202374."},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40266-013-0056-1."},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.6705\/j.jacme.202112_11(4).0001."},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201901-024OC."},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2015.15020262."},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.1464."},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.7326\/m18-1243."},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.8325."},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2022.01.006."},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-053487."},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.7799."},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss6901a1."},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/mlr.0000000000001719."},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3181c43103."},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mcna.2015.08.012."},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e31827fef7e."},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD000963.pub3."},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0143139."},{"key":"e_1_3_3_28_2","unstructured":"Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts. 2022. Accessed July 7 2022. https:\/\/www.apa.org\/depression-guideline#."},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2020.26.3.246."},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-021-01386-6."},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1177\/0269881115598411."},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1185\/03007995.2013.820694."},{"key":"e_1_3_3_33_2","unstructured":"Medicare Sample Group Indicator. Research Data Assistance Center. Accessed July 7 2022. https:\/\/resdac.org\/cms-data\/variables\/medicare-sample-group-indicator."},{"key":"e_1_3_3_34_2","unstructured":"What Medicare Covers. Center for Medicare and Medicaid Services. Accessed July 7 2022. https:\/\/www.medicare.gov\/what-medicare-covers."},{"key":"e_1_3_3_35_2","unstructured":"Chronic Conditions Data Warehouse. Accessed July 7 2022. https:\/\/www2.ccwdata.org\/web\/guest\/condition-categories."},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/0165-0327(88)90072-9."},{"key":"e_1_3_3_37_2","article-title":"American Psychiatric Association;","author":"American Psychiatric Association","year":"2013","unstructured":"American Psychiatric Association. DSM-5 diagnostic classification. In: Diagnostic and Statistical Manual of Mental Disorders. DSM Library. American Psychiatric Association; 2013.","journal-title":"Diagnostic and Statistical Manual of Mental Disorders"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1097\/jgp.0b013e3181987747."},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1080\/09540260500104524."},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-009-0039-4."},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjopharm.2006.06.006."},{"key":"e_1_3_3_42_2","first-page":"S31","article-title":"Perspectives on the management of insomnia in patients with chronic respiratory disorders","volume":"23","author":"George CF","year":"2000","unstructured":"George CF. Perspectives on the management of insomnia in patients with chronic respiratory disorders. Sleep. 2000;23(suppl 1):S31-S35.","journal-title":"Sleep"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.17.3.212."},{"issue":"5","key":"e_1_3_3_44_2","first-page":"339","article-title":"Deprescribing benzodiazepine receptor agonists: evidence-based clinical practice guideline","volume":"64","author":"Pottie K","year":"2018","unstructured":"Pottie K, Thompson W, Davies S, et al. Deprescribing benzodiazepine receptor agonists: evidence-based clinical practice guideline. Can Fam Physician. 2018;64(5):339-351.","journal-title":"Can Fam Physician"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-030858."},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2007.12.026."},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003709."},{"key":"e_1_3_3_48_2","doi-asserted-by":"publisher","DOI":"10.4065\/76.5.511."},{"key":"e_1_3_3_49_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201201-0034OC."},{"key":"e_1_3_3_50_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2013.05.001."},{"key":"e_1_3_3_51_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-017-0512-2."},{"key":"e_1_3_3_52_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199801000-00004."},{"key":"e_1_3_3_53_2","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-11-43."},{"key":"e_1_3_3_54_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa042580."},{"key":"e_1_3_3_55_2","doi-asserted-by":"publisher","DOI":"10.3892\/etm.2017.4102."},{"issue":"4","key":"e_1_3_3_56_2","article-title":"Comparison of the efficacy of a gabapentinoid with an opioid versus an opioid alone in patients with spinal cord stimulation","volume":"21","author":"Jang JS","year":"2018","unstructured":"Jang JS, Kwon Y, Hwang SM, et al. Comparison of the efficacy of a gabapentinoid with an opioid versus an opioid alone in patients with spinal cord stimulation. Pain Physician. 2018;21(4):E429-E434.","journal-title":"Pain Physician"},{"key":"e_1_3_3_57_2","doi-asserted-by":"publisher","DOI":"10.1002\/da.20600."},{"key":"e_1_3_3_58_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0304-3959(03)00301-4."},{"key":"e_1_3_3_59_2","doi-asserted-by":"publisher","DOI":"10.2147\/DHPS.S151073."},{"key":"e_1_3_3_60_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.20.2433."},{"key":"e_1_3_3_61_2","doi-asserted-by":"publisher","DOI":"10.21037\/apm-20-1455."},{"key":"e_1_3_3_62_2","first-page":"S276","article-title":"Opioid pharmacokinetic drug-drug interactions","volume":"17","author":"Overholser BR","year":"2011","unstructured":"Overholser BR, Foster DR. Opioid pharmacokinetic drug-drug interactions. Am J Manag Care. 2011;17(suppl 11):S276-S287.","journal-title":"Am J Manag Care"},{"key":"e_1_3_3_63_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.0194."},{"key":"e_1_3_3_64_2","doi-asserted-by":"publisher","DOI":"10.2190\/PM.45.2.g."},{"key":"e_1_3_3_65_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200804-619OC."},{"key":"e_1_3_3_66_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-014-1171-9."}],"container-title":["Annals of Pharmacotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10600280221113299","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10600280221113299","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10600280221113299","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:16:59Z","timestamp":1777375019000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10600280221113299"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,9]]},"references-count":65,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,4]]}},"alternative-id":["10.1177\/10600280221113299"],"URL":"https:\/\/doi.org\/10.1177\/10600280221113299","relation":{},"ISSN":["1060-0280","1542-6270"],"issn-type":[{"value":"1060-0280","type":"print"},{"value":"1542-6270","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,9]]}}}