Comparative Risk of Harm Associated with Zopiclone or Trazodone Use in Nursing Home Residents: a Retrospective Cohort Study in Alberta, Canada.
Background There is growing evidence of harm associated with trazodone and nonbenzodiazepine sedative hypnotics (e.g., zopiclone); however, their comparative risk of harm is unknown. Methods We conducted a retrospective cohort study with linked health administrative data, which enrolled older ( ≥66...
| Publicado en: | Canadian Geriatrics Journal Vol. 26; no. 1; pp. 9 - 23 |
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| Autores principales: | , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Canadian Geriatrics Society
Mar2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=162251458&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 162251458 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 19258348 EV2Z jtl: Canadian Geriatrics Journal issn: 19258348 maglogo: N pubinfo: dt: Mar2023 vid: 26 iid: 1 pid: 76420 pub: Canadian Geriatrics Society place: Markham, Ontario artinfo: ui: 162251458 162251458 162251458 10.5770/cgj.26.622 162251458 ppf: 9 ppct: 14 formats: fmt: @attributes: type: P tig: atl: Comparative Risk of Harm Associated with Zopiclone or Trazodone Use in Nursing Home Residents: a Retrospective Cohort Study in Alberta, Canada. aug: au: Watt, Jennifer A. Bronskill, Susan E. Meng Lin Youngson, Erik Ho, Joanne Hemmelgarn, Brenda Straus, Sharon E. Gruneir, Andrea affil: Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital-Unity Health Toronto, Toronto, ON sug: subj: Trazodone Therapeutic Use Trazodone Adverse Effects Eszopiclone Therapeutic Use Eszopiclone Adverse Effects Nursing Home Personnel Psychosocial Factors Osteoporotic Fractures Risk Factors Risk Assessment Manuscripts Canada Adverse Drug Event Prospective Studies Descriptive Statistics Retrospective Design Administrative Research Male Female Resistance Training Confidence Intervals Databases, Health Male Female ab: Background There is growing evidence of harm associated with trazodone and nonbenzodiazepine sedative hypnotics (e.g., zopiclone); however, their comparative risk of harm is unknown. Methods We conducted a retrospective cohort study with linked health administrative data, which enrolled older ( ≥66 years old) nursing home residents living in Alberta, Canada, between December 1, 2009, and December 31, 2018; the last followup date was June 30, 2019. We compared the rate of injurious falls and major osteoporotic fractures (primary outcome) and all-cause mortality (secondary outcome) within 180 days of first prescription of zopiclone or trazodone with cause-specific hazard models and inverse probability of treatment weights to control for confounding; primary analysis was intention-totreat and secondary analysis was per-protocol (i.e., residents censored if dispensed the other exposure drug). Results Our cohort included 1,403 residents newly dispensed trazodone and 1,599 residents newly dispensed zopiclone. At cohort entry, the mean resident age was 85.7 (standard deviation [SD] 7.4), 61.6% were female, and 81.2% had dementia. New zopiclone use was associated with similar rates of injurious falls and major osteoporotic fractures (intention-to-treat-weighted hazard ratio 1.15, 95% confidence interval [CI] 0.90-1.48; perprotocol-weighted hazard ratio 0.85, 95% CI 0.60-1.21) and all-cause mortality (intention-to-treat-weighted hazard ratio 0.96, 95% CI 0.79-1.16; per-protocol-weighted hazard ratio 0.90, 95% CI 0.66-1.23) compared to trazodone. Conclusions Zopiclone was associated with a similar rate of injurious falls, major osteoporotic fractures, and all-cause mortality compared to trazodone--suggesting one medication should not be used in lieu of the other. Appropriate prescribing initiatives should also target zopiclone and trazodone. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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