Long-term sedative use among community-dwelling adults: a population-based analysis

Weymann, Deirdre; Gladstone, Emilie J.; Smolina, Kate; Morgan, Steven G.

doi:10.9778/cmajo.20160056

Cited by 18 publications

(31 citation statements)

References 39 publications

(30 reference statements)

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“… -30 However, our findings showed that consumption after age 60 was lower than among those in the 49-59 age stratum, a somewhat suprising fact, as older individuals are described as the leading group of BZD users in many studies 25,26. Corroborating our finding, another study showed that long-term use of sedatives increased between 2004 and 2013 driven largely by increased use among middle-aged adults31 It also bears stressing that lifetime BZDC among adolescents (2.7%) was lower than previously reported in a Brazilian study (5%)32 and in a European study (5.6%) 33. The prevalence of BZD use was higher among women than among men, which is consistent with other international33 and Brazilian34 research.…”

Section: Discussionsupporting

confidence: 75%

Prevalence of and pathways to benzodiazepine use in Brazil: the role of depression, sleep, and sedentary lifestyle

Madruga

Paim

Palhares

et al. 2019

Braz. J. Psychiatry

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Objective:This study aimed to determine the prevalence of benzodiazepine (BZD) use in Brazil and to investigate the direct and indirect effects of alcohol consumption, sedentary lifestyle (SL), depressive symptoms (DS), and sleep dissatisfaction (SD) on BZD use.Methods:The Second Brazilian Alcohol and Drugs Survey (II BNADS) used stratified cluster probabilistic sampling to select 4,607 individuals aged 14 years and older from the Brazilian household population.Results:The lifetime and 12-month prevalence of BZD use was 9.8 and 6.1%, respectively. Older participants (age 40 and older) and women had higher rates. Alcohol use disorder, DS, and SD were significantly more prevalent in BZD users. The parallel multiple mediator model showed a positive direct effect of alcohol consumption on BZD use, with significant positive indirect effects of SL, SD, and DS as simultaneous mediators leading to higher BZD intake. Other statistically significant indirect pathways were DS alone, SD alone, and all of the above except SL.Conclusion:The prevalence of BZD use in Brazil is high compared to that of other countries. Knowledge of the main risk factors and pathways to consumption can guide prevention initiatives and underlie the development of better tailored and effective treatment strategies.

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Section: Discussionsupporting

confidence: 75%

Prevalence of and pathways to benzodiazepine use in Brazil: the role of depression, sleep, and sedentary lifestyle

Madruga

Paim

Palhares

et al. 2019

Braz. J. Psychiatry

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“…However, as the study was unable to differentiate between continuous users and patients who had significant periods without a prescription after initial exposure, this observation could be misleading. New and existing prescribing practice needs to be carefully monitored, as inappropriate use of these medications and dependence has also been identified among younger and middle‐aged populations . Therefore, without targeted interventions aimed at curtailing initiation; restricting duration of prescriptions to recommended periods; and weaning patients off these medicines, inappropriate long‐term use of benzodiazepines and Z‐drugs could persist for many generations to come.…”

Section: Discussionmentioning

confidence: 99%

“…Duration of consecutive benzodiazepine and Z-drug use for GMS-eligible individuals aged ≥16 years during study period inappropriate use of these medications and dependence has also been identified among younger and middle-aged populations [16,48,49]. Therefore, without targeted interventions aimed at curtailing initiation; restricting duration of prescriptions to recommended periods; and weaning patients off these medicines, inappropriate long-term use of benzodiazepines and Z-drugs could persist for many generations to come.…”

Section: Figurementioning

confidence: 99%

Benzodiazepine and Z‐drug prescribing in Ireland: analysis of national prescribing trends from 2005 to 2015

Cadogan

Ryan

Cahir

et al. 2018

Brit J Clinical Pharma

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Benzodiazepine prescribing to the GMS population in Ireland decreased significantly from 2005 to 2015, and was coupled with significant increases in Z-drug prescribing. The study shows that benzodiazepine and Z-drug prescribing is common in this population, with high proportions of individuals receiving long-term prescriptions. Targeted interventions are needed to reduce potentially inappropriate long-term prescribing and use of these medications in Ireland.

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“…Numerous countries have reported no notable changes, or only modest decreases, in benzodiazepine use in recent years [6][7][8][9]. In some instances, changes in benzodiazepine prescribing have been offset by increased Z-drug prescribing [5,[9][10][11] for which evidence of a more favourable risk profile is lacking [3].…”

Section: Introductionmentioning

confidence: 99%

Brief interventions targeting long‐term benzodiazepine and Z‐drug use in primary care: a systematic review and meta‐analysis

et al. 2020

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Aims To assess the effectiveness of brief interventions in primary care aimed at reducing or discontinuing long‐term benzodiazepine/Z‐drug (BZRA) use. Method Systematic review of randomized controlled trials of brief interventions in primary care settings aimed at reducing or discontinuing long‐term BZRA use in adults taking BZRAs for ≥ 3 months. Four electronic databases were searched: PubMed, EMBASE, PsycINFO and CENTRAL. The primary outcome was BZRA use, classified as discontinuation or reduction by ≥ 25%. The Theoretical Domains Framework (TDF) was used to retrospectively code behavioural determinants targeted by the interventions. The Behaviour Change Technique (BCT) Taxonomy was used to identify the interventions’ active components. Study‐specific estimates were pooled, where appropriate, to yield summary risk ratios (RRs) and 95% confidence intervals (CIs). Pearson's correlations were used to determine the relationship between intervention effect size and the results of both the TDF and BCT coding. Results Eight studies were included (n = 2071 patients). Compared with usual care, intervention patients were more likely to have discontinued BZRA use at 6 months (eight studies, RR = 2.73, 95% CI = 1.84–4.06) and 12 months post‐intervention (two studies, RR = 3.41, 95% CI = 2.22–5.25). TDF domains ‘knowledge’, ‘memory, attention and decision processes’, ‘environmental context and resources’ and ‘social influences’ were identified as having been included in every intervention. Commonly identified BCTs included ‘information about health consequences’, ‘credible source’ and ‘adding objects to the environment’. There was no detectable relationship between effect size and the results of either the TDF or BCT coding. Conclusion Brief interventions delivered in primary care are more effective than usual care in reducing and discontinuing long‐term benzodiazepine/Z‐drug use.

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Long-term sedative use among community-dwelling adults: a population-based analysis

Cited by 18 publications

References 39 publications

Prevalence of and pathways to benzodiazepine use in Brazil: the role of depression, sleep, and sedentary lifestyle

Prevalence of and pathways to benzodiazepine use in Brazil: the role of depression, sleep, and sedentary lifestyle

Benzodiazepine and Z‐drug prescribing in Ireland: analysis of national prescribing trends from 2005 to 2015

Brief interventions targeting long‐term benzodiazepine and Z‐drug use in primary care: a systematic review and meta‐analysis

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