Journal
EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY
Volume 79, Issue 8, Pages 1091-1105Publisher
SPRINGER HEIDELBERG
DOI: 10.1007/s00228-023-03515-2
Keywords
Benzodiazepines; Z-drugs; Long-term use; Prescription; Dispensation; Trajectory
Categories
Ask authors/readers for more resources
Despite being discouraged, long-term use of BZDR remains frequent. The study aimed to assess the proportion of long-term BZDR use in different age groups, identify 5-year BZDR use trajectories, and explore factors associated with long-term use and distinct trajectories. The findings highlight the importance of raising awareness and providing support to prescribers to make evidence-based decisions on BZDR treatment across the lifespan.
PurposeDespite 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.MethodsOur 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.ResultsIn 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.ConclusionsThe 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.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available