Document Detail


Determinants of chronic benzodiazepine use in the elderly: a longitudinal study.
MedLine Citation:
PMID:  18093258     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT: * The risk of adverse events due to chronic benzodiazepine use is high in the elderly. * Cross-sectional studies have shown that increasing age, female gender and poor physical and mental health are associated with benzodiazepine use. * When users were re-examined some years later, chronic somatic disease, pain and stress seemed to contribute to the continuation of benzodiazepine use.
WHAT THIS STUDY ADDS: * This is the first longitudinal study that analyzed the determinants of new-onset chronic benzodiazepine use in community-dwelling elderly. * Symptoms of depression, hypertension, pain related joint complaints and the perception of poor physical health predicted new-onset chronic use. Living alone was found to decrease the risk of chronic use.
AIMS: The risk of adverse events due to chronic benzodiazepine use is high in the elderly. Clinicians need to be able to identify those persons who are at risk of chronic benzodiazepine use, but little is known about the determinants. This study determined social and health related factors that predict new-onset chronic benzodiazepine use in community-dwelling elderly.
METHODS: This study was embedded in an ongoing cohort study among 5364 persons aged >or=57 years. Drug-dispensing medication records were available for the period between 1991 and 2003. We defined chronic benzodiazepine use as use during at least 180 days in a period of 365 consecutive days. The association of various social, psychiatric and somatic variables with new-onset chronic benzodiazepine use was studied with a Cox proportional hazards analysis.
RESULTS: Symptoms of depression, hypertension, pain related joint complaints and the perception of poor physical health predicted new-onset chronic use. In the subsample of participants who had filled at least one prescription in the follow-up period, of these variables only pain related joint complaints increased the risk of new-onset chronic use. Living alone protected against chronic benzodiazepine use.
CONCLUSIONS: The elderly with poor mental and physical health are at an increased risk of chronic benzodiazepine use. Living alone was found to decrease the risk of chronic use, which suggests that social factors may determine drug usage patterns. Very few characteristics predicted chronic benzodiazepine use once patients had received their first prescription. For clinicians, identification of patients at high risk is therefore not straightforward.
Authors:
Hendrika J Luijendijk; Henning Tiemeier; Albert Hofman; Jan Heeringa; Bruno H Ch Stricker
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Publication Detail:
Type:  Journal Article     Date:  2007-12-17
Journal Detail:
Title:  British journal of clinical pharmacology     Volume:  65     ISSN:  1365-2125     ISO Abbreviation:  Br J Clin Pharmacol     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-12     Completed Date:  2008-06-11     Revised Date:  2012-09-10    
Medline Journal Info:
Nlm Unique ID:  7503323     Medline TA:  Br J Clin Pharmacol     Country:  England    
Other Details:
Languages:  eng     Pagination:  593-9     Citation Subset:  IM    
Affiliation:
Erasmus Medical Centre, Department of Epidemiology and Biostatistics, Rotterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anti-Anxiety Agents / adverse effects*
Benzodiazepines / adverse effects*
Cohort Studies
Depression / complications,  drug therapy*,  psychology
Female
Humans
Longitudinal Studies
Male
Middle Aged
Netherlands
Pain / complications,  drug therapy*,  psychology
Proportional Hazards Models
Residence Characteristics
Risk Assessment / standards
Risk Factors
Sex Factors
Socioeconomic Factors
Chemical
Reg. No./Substance:
0/Anti-Anxiety Agents; 12794-10-4/Benzodiazepines
Comments/Corrections

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