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Objective: To determine the prevalence of use and misuse of prescription opioids among patients at Dutch emergency departments (EDs)., Design: Cross-sectional multicenter study., Method: This study was performed at three EDs in the Nijmegen-Arnhem region. ED-patients of 18 years and older were screened for current opioid use. The Current Opioid Misuse Measure (COMM) questionnaire was used to assess opioid misuse. The presence of opioid use disorder was determined using DSM-5 based interviews., Results: A total of 997 patients was screened for opioid use. The prevalence of opioid use was 15.0% (95%CI 12.9 -17.4). 22.6% (95%CI 14.6-32.4) scored positive for opioid misuse, 9.8% (95%CI 4.5-17.8) fulfilled DSM-5 criteria for opioid use disorder., Conclusion: Opioid use and misuse are relatively common among patients in Dutch EDs.

Most women use medication during pregnancy. The disposition of drugs may be altered due to changes in pregnant women's bodies. This may call for pregnancy-adjusted doses for certain medications. However, in the face of scarce evidence, such doses are generally lacking, potentially contributing to an increased risk of treatment failure or toxicity in pregnant women and their unborn children. By integrating physiological and/or population data, pharmacokinetic models can be used to determine appropriate medication dosages among pregnant women and their unborn children, as well as other patient groups for which evidence-based doses may be lacking such as children, elderly or obese patients. In order to translate model predictions into clinically usable doses, a number of conditions must be met, including careful model validation, an assessment of evidence from pharmacokinetic modelling alongside available clinical studies by multidisciplinary experts, as well as transparent communication towards end-users on the considerations for determining appropriate medication doses.