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

International Journal of Geriatric Psychiatry, 05/10/2012

Interventions are required to curb incident benzodiazepine prescriptions at their source both in hospitals and in ambulatory care settings.

Methods

  • Data were derived from 1189 community-dwelling adults aged 65 years naive to benzodiazepine consumption, enrolled in the Étude sur la Santé des Aines, 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.

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