CMAJ open
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Multicenter Study
Influence of opioid prescribing standards on health outcomes among patients with long-term opioid use: a longitudinal cohort study.
The College of Physicians and Surgeons of British Columbia introduced opioid prescribing standards and guidelines in mid-2016 in British Columbia. We evaluated impacts of the standards and guidelines on health outcomes. ⋯ Among patients with a history of long-term prescription opioid use, the regulatory prescribing standards and guidelines were not associated with changes in opioid overdose hospital admissions, all-cause emergency department visits, opioid overdose mortality or all-cause mortality, or with a sustained reduction in all-cause hospital admissions, over a 10-month period after they were introduced. Future research should investigate whether opioid prescribing standards or guidelines are associated with use of nonopioid analgesic medications or nonpharmacologic treatments.
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Multicenter Study Comparative Study Observational Study
Comparative effectiveness and safety of direct oral anticoagulants versus vitamin K antagonists in nonvalvular atrial fibrillation: a Canadian multicentre observational cohort study.
Direct oral anticoagulants (DOACs) have widely replaced warfarin for stroke prevention in nonvalvular atrial fibrillation. Our objective was to compare the safety and effectiveness of DOACs (dabigatran, rivaroxaban, apixaban) versus warfarin for stroke prevention in nonvalvular atrial fibrillation in the Canadian setting. ⋯ In this real-world study, DOACs were associated with similar risks of ischemic stroke or systemic embolization, and lower risks of bleeding and total mortality compared to warfarin. These findings support the use of DOACs for anticoagulation in nonvalvular atrial fibrillation.