Factors associated with long-term benzodiazepine and Z-drug use across the lifespan and 5-year temporal trajectories among incident users: a Swedish nationwide register-based study.
Purpose: Despite being discouraged by guidelines, long-term use of benzodiazepines and related Z-drugs (BZDR) remains frequent in the real-world. An improved understanding of factors associated with the transition from new to long-term BZDR use and of temporal BZDR use trajectories is needed. We aim...
| Publicado en: | European Journal of Clinical Pharmacology Vol. 79; no. 8; pp. 1091 - 1106 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Aug2023
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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=165466844&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 165466844 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00316970 NP9 jtl: European Journal of Clinical Pharmacology issn: 00316970 maglogo: N pubinfo: dt: Aug2023 vid: 79 iid: 8 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 165466844 164175010 165466844 165466844 10.1007/s00228-023-03515-2 165466844 ppf: 1091 ppct: 15 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Factors associated with long-term benzodiazepine and Z-drug use across the lifespan and 5-year temporal trajectories among incident users: a Swedish nationwide register-based study. aug: au: Isomura, Kayoko Wang, Xinchen Chang, Zheng Hellner, Clara Hasselström, Jan Ekheden, Isabella Jayaram-Lindström, Nitya Lichtenstein, Paul D'Onofrio, Brian M. Mataix-Cols, David Sidorchuk, Anna affil: Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden sug: subj: Drug Utilization Evaluation Antianxiety Agents, Benzodiazepine Therapeutic Use Zolpidem Therapeutic Use Eszopiclone Therapeutic Use Treatment Duration Evaluation Treatment Outcomes Evaluation Human Sweden Registries, Disease Prospective Studies Cox Proportional Hazards Model Multiple Logistic Regression Incidence Infant, Newborn Infant Child, Preschool Child Adolescence Adult Middle Age Aged Age Factors Risk Assessment Treatment Complications, Delayed Treatment Termination Drug Utilization Statistics and Numerical Data Descriptive Statistics Infant, Newborn: birth-1 month Infant: 1-23 months Child, Preschool: 2-5 years Child: 6-12 years Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years ab: Purpose: Despite being discouraged by guidelines, long-term use of benzodiazepines and related Z-drugs (BZDR) remains frequent in the real-world. An improved understanding of factors associated with the transition from new to long-term BZDR use and of temporal BZDR use trajectories is needed. We aimed to assess the proportion of long-term BZDR use (> 6 months) in incident BZDR-recipients across the lifespan; identify 5-year BZDR use trajectories; and explore individual characteristics (demographic, socioeconomic and clinical) and prescribing-related factors (pharmacological properties of the initial BZDR, prescriber's healthcare level, and concurrent dispensing of other medications) associated with long-term BZDR use and distinct trajectories. Methods: Our nationwide register-based cohort included all BZDR-recipients in Sweden with first dispensation in 2007–2013. Trajectories of BZDR use days per year were built using group-based trajectory modelling. Cox regression and multinomial logistic regression were fitted to assess the predictors of long-term BZDR use and trajectories' membership. Results: In 930,465 incident BZDR-recipients, long-term use increased with age (20.7%, 41.0%, and 57.4% in 0–17, 18–64, and ≥ 65-year-olds, respectively). Four BZDR use trajectories emerged, labelled 'discontinued', 'decreasing', 'slow decreasing' and 'maintained'. The proportion of the 'discontinued' trajectory members was the largest in all ages, but reduced from 75.0% in the youths to 39.3% in the elderly, whereas the 'maintained' increased with age from 4.6% to 36.7%. Prescribing-related factors, in particular multiple BZDRs at initiation and concurrent dispensing of other medications, were associated with increased risks of long-term (vs short-term) BZDR use and developing other trajectories (vs 'discontinued') in all age groups. Conclusions: The findings highlight the importance of raising awareness and providing support to prescribers to make evidence-based decisions on initiating and monitoring BZDR treatment across the lifespan. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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