TY  - JOUR
PY  - 2022//
TI  - Comparative safety of chronic versus intermittent benzodiazepine prescribing in older adults: a population-based cohort study
JO  - Journal of psychopharmacology
A1  - Davies, Simon Jc
A1  - Rudoler, David
A1  - de Oliveira, Claire
A1  - Huang, Anjie
A1  - Kurdyak, Paul
A1  - Iaboni, Andrea
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: Benzodiazepine treatment recommendations for older adults differ markedly between guidelines, especially their advice on the acceptability of long-term use. AIMS: Using population-based data we compared risks associated with chronic versus intermittent benzodiazepine usage in older adults. The primary outcome was falls resulting in hospital/emergency department visits. <br><br>METHODS: We undertook a retrospective population-based cohort study using linked healthcare databases in adults aged ⩾ 66 years in Ontario, Canada, with a first prescription for benzodiazepines. Chronic and intermittent benzodiazepine users, based on the 180 days from index prescription, were matched (1:2 ratio) by sex, age and propensity score, then followed for up to 360 days. Hazard ratios (HRs) for outcomes were calculated from Cox regression models. <br><br>RESULTS: A total of 57,041 chronic and 113,839 matched intermittent users were included. Hospitalization/emergency department visits for falls occurred during follow up in 4.6% chronic versus 3.2% intermittent users (HR = 1.13, 95% confidence interval (CI): 1.08 to 1.19; p < 0.0001). There were significant excess risks in chronic users for most secondary outcomes: hip fractures, hospitalizations/emergency department visits, long-term care admission and death, but not wrist fractures. Adjustment for benzodiazepine dosage had minimal impact on HRs. <br><br>CONCLUSION: Our study demonstrates evidence of significant excess risks associated with chronic benzodiazepine use compared to intermittent use. The excess risks may inform decision-making by older adults and clinicians about whether short- or long-term benzodiazepine use is a reasonable option for symptom management.<p />  <p>Language: en</p>
LA  - en
SN  - 0269-8811
UR  - http://dx.doi.org/10.1177/02698811211069096
ID  - ref1
ER  -