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Increased morbidity and mortality related to asthma among asthmatic patients who use major tranquillisers

BMJ 1996; 312 doi: https://doi.org/10.1136/bmj.312.7023.79 (Published 13 January 1996) Cite this as: BMJ 1996;312:79
  1. K S Joseph,
  2. Lucie Blais, doctoral scholara,
  3. Pierre Ernst, associate professora,
  4. Samy Suissa, associate professora
  1. a Department of Epidemiology and Biostatistics, McGill Pharmacoepidemiology Research Unit, McGill University, Montreal, Quebec, Canada H3A 1A2 KS Joseph, research fellow
  1. Correspondence to: Dr K S Joseph, Royal Victoria Hospital, Division of Clinical Epidemiology, 687 Pine Avenue West, Ross 4, Montreal, Quebec, Canada H3A 1A1.Reprint requests to: Dr S Suissa, Royal Victoria Hospital, Division of Clinical Epidemiology, 687 Pine Avenue West, Ross 4, Montreal, Quebec, Canada H3A 1A1.
  • Accepted 1 November 1995

Abstract

Objective: To assess the potentially increased risk of death or near death from asthma in asthmatic patients with psychosis.

Design: Case-control study.

Setting: The computerised health databases of the Canadian province of Saskatchewan.

Subjects: 131 cases of death or near death from asthma identified within a cohort of asthmatic patients; 3930 matched non-cases.

Exposure and outcome measures: The exposure of interest was the use of major tranquillisers in the period before an outcome event. Outcomes included death or near death from asthma.

Results: Crude analyses showed that asthmatic patients who had used major tranquillisers in the previous 12 months were at a 3.2 (95% confidence interval 1.4 to 7.5) times greater risk of death or near death from asthma than asthmatic patients who did not use major tranquillisers. Past users of major tranquillisers who had recently discontinued use were at a particularly high risk (relative risk 6.6; 2.5 to 17.6). Adjustment for use of antiasthma drugs and other confounders abolished this excess risk.

Conclusions: Asthmatic patients who use major tranquillisers seem to be at an increased risk of death or near death from asthma. Physicians treating asthmatic patients with a history of use of major tranquillisers should exercise greater caution with regard to management of such patients.

Key messages

  • Key messages

  • Past users of major tranquillisers who have recently discontinued use are at particularly high risk

  • Physicians treating asthmatic patients should consider a history of use of major tranquillisers as a marker for identifying patients at higher risk for the serious complications of asthma

Footnotes

  • Funding Boehringer Ingelheim Pharmaceuticals Canada. PE and SS are research scholars of the Fonds de la Recherche en Sante du Quebec (FRSQ). LB is the recipient of a doctoral scholarship from the National Health and Research Development Program of Canada. The McGill Pharmacoepidemiology Research Unit is funded by the FRSQ.

  • Conflict of interest None.

  • Accepted 1 November 1995
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