Predictors of the incidence and discontinuation of long-term use of benzodiazepines: A population-based study

Division of Mental Health and Addiction Medicine, Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Rd., Zhunan, Miaoli County 350, Taiwan.
Drug and alcohol dependence (Impact Factor: 3.42). 07/2009; 104(1-2):140-6. DOI: 10.1016/j.drugalcdep.2009.04.017
Source: PubMed


Long-term use of benzodiazepines (BZDs) has been linked with an array of negative health consequences and increased medical costs and social burden. In this study, we sought to investigate the factors accounting for differential risks in the process from incident BZD use to long-term use and discontinuation in the general population. On the basis of a random sample of 187,413 people enrolled in Taiwan's National Health Insurance program on January 1, 2000, data of 2000-2002 healthcare and pharmacological services utilization were retrieved. Long-term use (LTU) was defined by having received BZD prescriptions for 180 or more days within any given calendar year. Multivariate logistic regression analyses were carried out to assess the strength of associations while adjusting for the effects of individual sociodemographics, service providers, and pharmacological agents simultaneously. Results indicated that males, elderly, and those with physical or mental disorders were more likely to become long-term users of BZDs. Having received BZD prescriptions in multiple pharmacological agents, short-acting or mixed-type agents, and hypnotic indication were associated with a roughly 2- to 5-fold increased risk of BZD LTU soon after prescription initiation. With respect to discontinuation, the effects of pharmacological characteristics seem more salient as compared to those of individual and service-provider factors. Future strategies targeting individual factors and modifying service-provider prescription behaviors may be considered to reduce possible negative consequences of BZD LTU.

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Available from: Chuan-Yu Chen, Mar 18, 2015
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    • "The volume of the initial or overall BZD prescriptions (measured by units or by the overall prescribed dosage) was an important predictor of long-term use (Table 5). Long-term use was also more common if the patient received prescriptions for more than one BZD concurrently [50] [66]. Studies comparing initial and previous BZD users found that previous BZD use was more frequently associated with later long-term use [35] [52] [56] [57]. "
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    • "Female patients showed a greater reduction of QoL compared to males, at least in some of the explored items. This observation is in line with previous reported data, at least for a higher prevalence of BZD dependence among females (Lader, 2011; Fang et al., 2009; Petitjean et al., 2007). "
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    No preview · Article · Jul 2015 · Journal of Affective Disorders
    • "Prevalence of benzodiazepine (BZD) use among individuals aged 65 and over varies between 10% and 42% (Madhusoodanan & Bogunovic, 2004). Long-term use, in addition to old age, is related to depressive symptoms and insomnia (Dealberto, Seeman, McAvay, & Berkman, 1997; Isacson, 1997; Luijendijk, Tiemeier, Hofman, Heeringa, & Stricker, 2008), as well as other comorbid physical and psychological health problems (Fang et al., 2009). The usage increases with age (Jorm, Grayson, Creasey, Waite, & Broe, 2000; Pr eville et al., 2012), even after controlling for physical and mental health (Pr eville, H ebert, Boyer, & Bravo, 2001), including individuals aged over 75 (Johnell & Fastbom, 2009). "
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