{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T02:50:05Z","timestamp":1788922205099,"version":"build-2803163510"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:00:00Z","timestamp":1750809600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The aim was to assess the associations between morphine, fentanyl and adverse events in primary care patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective, propensity-score-weighted cohort study using a primary-care database covering &amp;gt;75% population of Catalonia, Spain was conducted. Patients aged \u226518\u00a0years with \u22651\u00a0year of available data and incident dispensation of morphine or fentanyl, were included from 1st January 2007 to 31st December 2017. Outcomes were all-cause mortality, cardiac arrhythmias, fractures (hip, pelvis, vertebra, wrist, humerus), constipation, delirium, falls, opioid abuse\/dependence, and sleep disorders while on treatment. Risk ratios (RRs) and hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using cause-specific Cox models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 12,632 patients (3,040 with morphine and 9,695 with fentanyl) were included (median [IQR] age, 78.4 [63.8; 86.1] years; 63.6% female). Compared with morphine, fentanyl dispensation was associated with a higher risk of fractures (incidence: 6.92 vs. 4.13 per 1,000 dispensations-month; HR, 1.63 [95% CI, 1.15\u20132.32]; RR, 1.78 [95% CI, 1.25\u20132.53]), especially in men and in those &amp;lt;65 and over &amp;gt;80\u00a0years old. No difference was observed for the rest of outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Among outpatients, a new prescription dispensation of fentanyl, compared with morphine, was associated with a higher risk of fractures. The findings should be interpreted cautiously given the potential for residual confounding.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphar.2025.1579634","type":"journal-article","created":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T04:10:56Z","timestamp":1750824656000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Association of morphine vs. fentanyl prescription dispensation with adverse clinical outcomes"],"prefix":"10.3389","volume":"16","author":[{"given":"Carlen","family":"Reyes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Antonia","family":"Pou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesar","family":"Diaz-Torne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Carbonell-Abella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Brotons","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Martinez-Laguna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,25]]},"reference":[{"key":"B1","unstructured":"Utilizaci\u00f3n de Medicamentos Analg\u00e9sicos Opioides en Espa\u00f1a\n          \n          \n          2024"},{"key":"B2","doi-asserted-by":"publisher","first-page":"3247","DOI":"10.2147\/IJGM.S419239","article-title":"Pharmacological methods of pain management: narrative review of medication used","volume":"31","author":"Alorfi","year":"2023","journal-title":"Int. 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