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COPD and asthma in patients with opioid dependency: a cross-sectional study in primary care

Patients treated for drug addiction have high asthma and COPD prevalence rates. The relative contributions of cigarette smoking, smoking intensity and possible smoking of other substances has not been described. We aimed to describe the prevalence and determinants of asthma and COPD in patients pres...

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Autores principales: Mehta, S., Parmar, N., Kelleher, M., Jolley, C. J., White, P., Durbaba, S., Ashworth, M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6959319/
https://www.ncbi.nlm.nih.gov/pubmed/31937808
http://dx.doi.org/10.1038/s41533-019-0161-7
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author Mehta, S.
Parmar, N.
Kelleher, M.
Jolley, C. J.
White, P.
Durbaba, S.
Ashworth, M.
author_facet Mehta, S.
Parmar, N.
Kelleher, M.
Jolley, C. J.
White, P.
Durbaba, S.
Ashworth, M.
author_sort Mehta, S.
collection PubMed
description Patients treated for drug addiction have high asthma and COPD prevalence rates. The relative contributions of cigarette smoking, smoking intensity and possible smoking of other substances has not been described. We aimed to describe the prevalence and determinants of asthma and COPD in patients prescribed methadone as opioid substitution therapy (OST). In a cross-sectional study of an anonymised patient-level primary care dataset of UK inner-city general practices (n = 46), 321,395 patients aged ≥18 years were identified. A total of 676 (0.21%) had a record of a methadone ever issued in primary care. The association between respiratory disease and methadone prescribing was examined using logistic regression. Models were adjusted for potential effects of clustering by practice. A total of 97.3% of patients prescribed methadone were cigarette smokers, either current (81.2%) or ex-smokers (16.1%). The prevalences of asthma and COPD were higher in methadone patients (14.2% and 12.4%, respectively) compared to non-methadone patients (4.4% and 1.1%, respectively). Methadone was an independent determinant of asthma, adjusting for smoking status (OR 3.21; 95% CI: 2.52, 4.10) or for smoking intensity (3.08; 2.27, 4.19), and of COPD, adjusting for smoking status (6.00; 4.61, 7.80) or for smoking intensity (5.80; 4.12, 8.17). COPD and asthma prevalence were substantially higher in those prescribed methadone compared to those never prescribed methadone. Prescription of methadone was an independent predictor for both COPD and asthma, even after adjustment for smoking status and smoking intensity. Possible explanations include confounding by association with smoking of heroin or crack cocaine, both of which may have a causal association with COPD and asthma.
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spelling pubmed-69593192020-01-22 COPD and asthma in patients with opioid dependency: a cross-sectional study in primary care Mehta, S. Parmar, N. Kelleher, M. Jolley, C. J. White, P. Durbaba, S. Ashworth, M. NPJ Prim Care Respir Med Article Patients treated for drug addiction have high asthma and COPD prevalence rates. The relative contributions of cigarette smoking, smoking intensity and possible smoking of other substances has not been described. We aimed to describe the prevalence and determinants of asthma and COPD in patients prescribed methadone as opioid substitution therapy (OST). In a cross-sectional study of an anonymised patient-level primary care dataset of UK inner-city general practices (n = 46), 321,395 patients aged ≥18 years were identified. A total of 676 (0.21%) had a record of a methadone ever issued in primary care. The association between respiratory disease and methadone prescribing was examined using logistic regression. Models were adjusted for potential effects of clustering by practice. A total of 97.3% of patients prescribed methadone were cigarette smokers, either current (81.2%) or ex-smokers (16.1%). The prevalences of asthma and COPD were higher in methadone patients (14.2% and 12.4%, respectively) compared to non-methadone patients (4.4% and 1.1%, respectively). Methadone was an independent determinant of asthma, adjusting for smoking status (OR 3.21; 95% CI: 2.52, 4.10) or for smoking intensity (3.08; 2.27, 4.19), and of COPD, adjusting for smoking status (6.00; 4.61, 7.80) or for smoking intensity (5.80; 4.12, 8.17). COPD and asthma prevalence were substantially higher in those prescribed methadone compared to those never prescribed methadone. Prescription of methadone was an independent predictor for both COPD and asthma, even after adjustment for smoking status and smoking intensity. Possible explanations include confounding by association with smoking of heroin or crack cocaine, both of which may have a causal association with COPD and asthma. Nature Publishing Group UK 2020-01-14 /pmc/articles/PMC6959319/ /pubmed/31937808 http://dx.doi.org/10.1038/s41533-019-0161-7 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Mehta, S.
Parmar, N.
Kelleher, M.
Jolley, C. J.
White, P.
Durbaba, S.
Ashworth, M.
COPD and asthma in patients with opioid dependency: a cross-sectional study in primary care
title COPD and asthma in patients with opioid dependency: a cross-sectional study in primary care
title_full COPD and asthma in patients with opioid dependency: a cross-sectional study in primary care
title_fullStr COPD and asthma in patients with opioid dependency: a cross-sectional study in primary care
title_full_unstemmed COPD and asthma in patients with opioid dependency: a cross-sectional study in primary care
title_short COPD and asthma in patients with opioid dependency: a cross-sectional study in primary care
title_sort copd and asthma in patients with opioid dependency: a cross-sectional study in primary care
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6959319/
https://www.ncbi.nlm.nih.gov/pubmed/31937808
http://dx.doi.org/10.1038/s41533-019-0161-7
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