Uncovering the source of new benzodiazepine prescriptions in community-dwelling older adults

Objective Initiatives to reduce benzodiazepine use have been largely unsuccessful despite strong associations with adverse outcomes. Curtailing incident use of benzodizepines is an alternate strategy that has yet to be explored. This study aims to determine the source of incident benzodiazepine pres...

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Bibliographic Details
Published in:International journal of geriatric psychiatry 2013-03, Vol.28 (3), p.248-255
Main Authors: Halme, Alex S., Beland, Sarah-Gabrielle, Preville, Michel, Tannenbaum, Cara
Format: Article
Language:English
Subjects:
Age
Aged
Aged, 80 and over
Ambulatory care
Ambulatory Care Facilities - statistics & numerical data
Antidepressants
Benzodiazepine
benzodiazepines
Benzodiazepines - therapeutic use
Biological and medical sciences
Data processing
Discharge
Drug Prescriptions - statistics & numerical data
Drug use
Drugs
Female
General aspects
Geriatric psychiatry
Geriatrics
Health Surveys
hospitalization
Hospitals
Humans
inappropriate prescribing
Inappropriate Prescribing - statistics & numerical data
incidence
Intervention
Inventories
Male
Medical sciences
Miscellaneous
Multivariate Analysis
Older people
Patient Discharge - statistics & numerical data
Poisson Distribution
Prescriptions
Prospective Studies
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Psychotropic drugs
Public health. Hygiene
Public health. Hygiene-occupational medicine
Quebec
Regression analysis
Side effects
Surveys and Questionnaires
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Summary:Objective Initiatives to reduce benzodiazepine use have been largely unsuccessful despite strong associations with adverse outcomes. Curtailing incident use of benzodizepines is an alternate strategy that has yet to be explored. This study aims to determine the source of incident benzodiazepine prescriptions by comparing the risk of receiving a new prescription upon hospital discharge versus after an ambulatory care clinic visit. Methods Data were derived from 1189 community‐dwelling adults aged 65 years naive to benzodiazepine consumption, enrolled in the Étude sur la Santé des Ainés, a prospective 3‐year cohort study conducted in Québec, Canada. Health survey questionnaires were linked with provincial administrative databases of prescription and health service claims. Analysis with multivariate Poisson regression models compared the risk of incident benzodiazepine use post‐hospitalization versus after an ambulatory care visit. Models were adjusted for sex, age, antidepressant use, and concomitant drugs. Sub‐analyses were conducted for chronic prescriptions. Results Incident benzodiazepine use was 11% over a 2‐year period, with 18.3% of prescriptions leading to chronic use (> 90 days). Hospitalization conferred a 2.7‐fold greater risk of incident use than an outpatient visit (OR 2.66, 95% CI 1.78–3.98) and a 4.7‐fold (OR 4.74, 95% CI 1.63–13.78) increased risk of chronic use, after adjusting for potential confounders. Despite the increased risk, only 13% of new prescriptions originated post‐hospital discharge, with the remainder prescribed during outpatient visits. Conclusion Interventions are required to curb incident benzodiazepine prescriptions at their source both in hospitals and in ambulatory care settings. Copyright © 2012 John Wiley & Sons, Ltd.
ISSN:0885-6230
1099-1166
DOI:10.1002/gps.3818