Risk of long-term benzodiazepine and Z-drug use following the first prescription among community-dwelling adults with anxiety/mood and sleep disorders: a retrospective cohort study.
anxiety disorders
clinical pharmacology
primary care
psychiatry
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
01 11 2021
01 11 2021
Historique:
entrez:
2
11
2021
pubmed:
3
11
2021
medline:
15
12
2021
Statut:
epublish
Résumé
To measure the incidence of long-term benzodiazepine receptor agonist (BZRA) use among individuals with anxiety, mood and/or sleep disorders. To identify factors associated with long-term use following the first prescription. This was a population-based retrospective cohort study using administrative databases in Manitoba, Canada. Individuals with anxiety/mood or sleep disorder who received their first BZRA between 1 April 2001 and 31 March 2015 were included. Long-term use was defined as ≥180 days. Logistic regression modelling was used to examine predictors of long-term use. Among 206 933 individuals included, long-term BZRA use in the first episode of use was 4.5% (≥180 days) following their first prescription. Factors associated with ≥180 days of use included male sex (adjusted OR (aOR) 1.33, 95% CI 1.27 to 1.39), age ≥65 (aOR 5.15, 95% CI 4.81 to 5.52), income assistance (aOR 1.68, 95% CI 1.55 to 1.81), previous non-BZRA psychotropic (aOR 1.93, 95% CI 1.83 to 2.02) or opioid use (aOR 1.16, 95% CI 1.11 to 1.22), high comorbidity (aOR 1.43, 95% CI 1.32 to 1.55), high healthcare use (aOR 1.46, 95% CI 1.33 to 1.60) and psychiatrist prescriber (aOR 2.11, 95% CI 1.93 to 2.32). Less than 1 in 20 patients use BZRAs ≥180 days in their first treatment episode. Several factors were associated with long-term use following the first prescription and further investigation into whether these factors need to be considered at the point of prescribing is warranted. In light of these findings, future research should examine the predictors of cumulative repeat episodes of BZRA exposure.
Identifiants
pubmed: 34725071
pii: bmjopen-2020-046916
doi: 10.1136/bmjopen-2020-046916
pmc: PMC8562522
doi:
Substances chimiques
Pharmaceutical Preparations
0
Benzodiazepines
12794-10-4
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e046916Subventions
Organisme : AHRQ HHS
ID : U18 HS020498
Pays : United States
Informations de copyright
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Eur Psychiatry. 2013 Jan;28(1):7-20
pubmed: 22521806
J Psychiatr Res. 2018 Feb;97:94-100
pubmed: 29223863
Br J Clin Pharmacol. 2008 Apr;65(4):593-9
pubmed: 18093258
J Psychopharmacol. 2014 May;28(5):403-39
pubmed: 24713617
Br J Clin Pharmacol. 2014 Feb;77(2):295-301
pubmed: 22882333
J Clin Psychiatry. 2010 Feb;71(2):194-200
pubmed: 20193647
BMJ Open. 2019 Jul 26;9(7):e029641
pubmed: 31350250
JAMA Psychiatry. 2015 Feb;72(2):136-42
pubmed: 25517224
CMAJ Open. 2014 Oct 01;2(4):E208-16
pubmed: 25485245
Osteoporos Int. 2014 Jan;25(1):105-20
pubmed: 24013517
Fam Pract. 2013 Aug;30(4):404-10
pubmed: 23515374
Pharmacoepidemiol Drug Saf. 2017 May;26(5):544-553
pubmed: 28266748
Eur Psychiatry. 2015 Nov;30(8):1037-47
pubmed: 26545257
Expert Opin Drug Saf. 2014 Jul;13(7):919-34
pubmed: 24905348
Psychiatr Serv. 2016 Sep 1;67(9):1012-8
pubmed: 27133727
Psychiatr Serv. 2003 Jul;54(7):1006-11
pubmed: 12851438
Pharmacoepidemiol Drug Saf. 2011 Apr;20(4):378-85
pubmed: 21259378
Health Policy. 2010 Oct;97(2-3):122-9
pubmed: 20413177
Basic Clin Pharmacol Toxicol. 2017 Mar;120(3):292-298
pubmed: 27717229
JAMA Psychiatry. 2015 Feb;72(2):110-1
pubmed: 25517135
Drugs R D. 2017 Dec;17(4):493-507
pubmed: 28865038
Pharmacoepidemiol Drug Saf. 2017 Dec;26(12):1555-1560
pubmed: 29027336
Int J Clin Pract. 2015 Nov;69(11):1275-80
pubmed: 26133234
CNS Drugs. 2016 Jan;30(1):1-7
pubmed: 26715389
Drug Alcohol Depend. 2009 Sep 1;104(1-2):140-6
pubmed: 19515515
Sleep Med. 2015 Apr;16(4):477-82
pubmed: 25761665
Aust N Z J Public Health. 2001 Oct;25(5):464-9
pubmed: 11688629
Scand J Prim Health Care. 2015;33(4):252-9
pubmed: 26683285
Eur Respir J. 2014 Aug;44(2):284-6
pubmed: 25082905
Eur J Clin Pharmacol. 2012 Mar;68(3):311-9
pubmed: 21928085
J Chronic Dis. 1987;40(5):373-83
pubmed: 3558716
BMJ Open. 2019 Dec 30;9(12):e030803
pubmed: 31892646
Patient. 2017 Feb;10(1):1-15
pubmed: 27282559
Psychol Med. 2010 Sep;40(9):1495-505
pubmed: 19939327
BMC Fam Pract. 2013 Dec 13;14:191
pubmed: 24330388
Int J Psychiatry Clin Pract. 2012 Jun;16(2):77-84
pubmed: 22540422
Aust N Z J Public Health. 2000 Feb;24(1):7-10
pubmed: 10777971
J Clin Epidemiol. 1996 Sep;49(9):1067-73
pubmed: 8780618
Ann Intern Med. 2016 Jul 19;165(2):125-33
pubmed: 27136449
Soc Sci Med. 1999 Aug;49(4):459-67
pubmed: 10414806
J Clin Psychiatry. 2005;66 Suppl 2:28-33
pubmed: 15762817
Drugs Real World Outcomes. 2016 Sep;3(3):289-296
pubmed: 27747828
J Anxiety Disord. 2011 May;25(4):554-62
pubmed: 21315551
CNS Drugs. 2009;23(1):19-34
pubmed: 19062773
Br J Clin Pharmacol. 2011 Feb;71(2):263-72
pubmed: 21219408
Prim Care Companion CNS Disord. 2017 Mar 2;19(2):
pubmed: 28257172
Can J Psychiatry. 2010 Dec;55(12):792-9
pubmed: 21172100
Can J Psychiatry. 2010 Nov;55(11):709-14
pubmed: 21070698
J Clin Epidemiol. 2001 Oct;54(10):979-85
pubmed: 11576808
Int J Epidemiol. 2014 Dec;43(6):1969-85
pubmed: 25080530
J Clin Psychiatry. 2009 Apr 21;70(5):663-73
pubmed: 19389334
J Clin Sleep Med. 2017 Feb 15;13(2):307-349
pubmed: 27998379
BMC Psychiatry. 2014;14 Suppl 1:S1
pubmed: 25081580
Pharmacoepidemiol Drug Saf. 2018 Jun;27(6):674-682
pubmed: 29726630