| Autor: |
Yanning Wang, Debbie L. Wilson, Deanna Fernandes, Lauren E. Adkins, Ashley Bantad, Clint Copacia, Nilay Dharma, Pei-Lin Huang, Amanda Joseph, Tae Woo Park, Jeffrey Budd, Senthil Meenrajan, Frank A. Orlando, John Pennington, Siegfried Schmidt, Ronald Shorr, Constance R. Uphold, Wei-Hsuan Lo-Ciganic |
| Jazyk: |
angličtina |
| Rok vydání: |
2023 |
| Předmět: |
|
| Zdroj: |
Journal of Clinical Medicine, Vol 12, Iss 5, p 1788 (2023) |
| Druh dokumentu: |
article |
| ISSN: |
2077-0383 |
| DOI: |
10.3390/jcm12051788 |
| Popis: |
While the Food and Drug Administration’s black-box warnings caution against concurrent opioid and benzodiazepine (OPI–BZD) use, there is little guidance on how to deprescribe these medications. This scoping review analyzes the available opioid and/or benzodiazepine deprescribing strategies from the PubMed, EMBASE, Web of Science, Scopus, and Cochrane Library databases (01/1995–08/2020) and the gray literature. We identified 39 original research studies (opioids: n = 5, benzodiazepines: n = 31, concurrent use: n = 3) and 26 guidelines (opioids: n = 16, benzodiazepines: n = 11, concurrent use: n = 0). Among the three studies deprescribing concurrent use (success rates of 21–100%), two evaluated a 3-week rehabilitation program, and one assessed a 24-week primary care intervention for veterans. Initial opioid dose deprescribing rates ranged from (1) 10–20%/weekday followed by 2.5–10%/weekday over three weeks to (2) 10–25%/1–4 weeks. Initial benzodiazepine dose deprescribing rates ranged from (1) patient-specific reductions over three weeks to (2) 50% dose reduction for 2–4 weeks, followed by 2–8 weeks of dose maintenance and then a 25% reduction biweekly. Among the 26 guidelines identified, 22 highlighted the risks of co-prescribing OPI–BZD, and 4 provided conflicting recommendations on the OPI–BZD deprescribing sequence. Thirty-five states’ websites provided resources for opioid deprescription and three states’ websites had benzodiazepine deprescribing recommendations. Further studies are needed to better guide OPI–BZD deprescription. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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