Association Between Concurrent Use of Benzodiazepines and Opioids and Health Care Utilization Among Patients With Cancer in Puerto Rico.

PURPOSE: To evaluate the association between concurrent use of opioids and benzodiazepines (BZDs) and emergency room (ER) visits and hospital admissions in patients with cancer. METHODS: Data were obtained from the Puerto Rico Central Cancer Registry-Health Insurance Linkage. Odds ratios (ORs) with 95% CIs and incidence rate ratio (IRR) were estimated using logistic and negative binomial regression analyses to assess the association between concurrent use of opioids and BZDs (overlap of at least 7 days) and ER visits and hospital admissions. RESULTS: A total of 9,259 patients were included in the main analysis. The logistic regression results showed a significant association between concurrent use of opioids and BZDs and at least one ER visit (OR, 1.28 [95% CI, 1.07 to 1.54]) or hospital admission (OR, 1.42 [95% CI, 1.18 to 1.71]) compared with individuals with BZDs alone, after adjusting for age, sex, comorbidity index, cancer stage, health insurance, and health region. Compared with individuals with opioid use alone, the association did not reach significance. In the negative binomial regression, a significant association was observed for ER visits (IRR, 1.52 [95% CI, 1.31 to 1.76]) and hospitalizations (IRR, 1.34 [95% CI, 1.20 to 1.50]) when compared with individuals with BZDs alone. Compared with individuals with opioids alone, it only reached significance for ER visits (IRR, 1.39 [95% CI, 1.20 to 1.61]). CONCLUSION: Careful evaluation must be done before prescribing concurrent opioids and BZDs in patients with cancer, as the results suggest that coprescribing may increase the odds of ER visits and hospitalizations.

Knowledge and Perceptions of E-cigarettes and the Motivations for their Use: Talking to Smokers (E-cigarettes and/or Conventional Cigarettes) and Non-smokers in Puerto Rico.

OBJECTIVE: The awareness and use of e-cigarettes have been increasing in recent years. The World Health Organization recently reported that regulations are needed to impede the promotion of e-cigarettes to young people, prohibit unproven health claims about them (including those regarding smoking-cessation efficacy), minimize potential health risks to e-cigarette users and non-users, and protect existing tobacco controls. The study described herein explored e-cigarette knowledge, perceptions, and usage motivations among a group of adults in Puerto Rico. METHODS: This research study used a validated questionnaire with closed-ended questions to gather data. Non-inferential and inferential statistics were used to characterize smokers (of e-cigarettes, of conventional cigarettes, and of both) and non-smokers. RESULTS: A total of 415 respondents took part; they were evenly distributed by gender, age, and socioeconomic status; all were residents of Puerto Rico at the time of the survey. The overall awareness of e-cigarettes was high, but knowledge of nicotine content and regulations was limited. Asked whether e-cigarettes contain nicotine (they do not), approximately two thirds stated either that they do or that they didn't know; asked whether e-cigarettes are regulated as a tobacco product (they are in Puerto Rico), 84% stated either that they are not or that they didn't know. Common perceptions of e-cigarettes are that they are harmful to health and that they are no less harmful than cigarettes are. However, a significant portion of the respondents perceived e-cigarettes to be less addictive than conventional cigarettes are. Overall, the respondents were divided on the efficacy of e-cigarettes for smoking cessation. Nonetheless, the most common motivation for their use, according to both current users and potential future users, is to aid in smoking cessation or reduction. CONCLUSION: The majority of individuals surveyed were aware of e-cigarettes but had limited knowledge of their contents or regulation. As an aid in smoking cessation was the most commonly mentioned motivation for e-cigarette use.