Abstract
IntroductionThe long-term use of benzodiazepines (BZD) and z-drugs in older populations is associated with a variety of sociodemographic and health-related factors. Recent studies reported that long-term BZD and z-drugs use is associated with increased age, female sex, and severe negative psychological (e.g., depression) and somatic (e.g., chronic disease) factors. The current study explores the sociodemographic and health-related factors associated with long-term BZD and z-drugs use in the elderly.MethodsWe conducted a cross-sectional survey among randomly selected patients of one health insurance plan (“AOK North-West”) with BZD and z-drugs prescriptions in the past 12 months. The sample was stratified by appropriate German prescription guidelines (yes vs. no) and age (50–65 vs. >65 years). To examine the association of selected sociodemographic and psychological variables (e.g., sex, employment status, quality of life, depression) with long-term use, a binary logistic regression analysis was conducted.ResultsIn total, data from 340 patients were analyzed. The mean age was 72.1 (SD = 14.5) years, and the most commonly used substances were zopiclon (38.1%), oxazepam (18.1%), and lorazepam (13.8%). The mean defined daily dose (DDD) was 0.73 (SD = 0.47). Insomnia was the main reason for prescribing BZD and z-drugs. The long-term use of BZD and z-drugs was significantly associated with unemployment (OR = 2.9, 95% CI [1.2–7.1]) and generally problematic medication use (OR = 0.5, 95% CI [0.2–1.0]).DiscussionUnemployment status and problematic medication use had a significant association with the patient-reported, long-term use of BZD and z-drugs. Divergent prescription patterns might suggest problematic patterns of BZD and z-drugs use. The causal connection between the identified factors and problematic BZD and z-drugs prescription is not discussed in this paper. Nevertheless, employment status and possible evidence of general problematic drug use may be a warning signal to the prescribers of BZD and z-drugs.
Highlights
The long-term use of benzodiazepines (BZD) and z-drugs in older populations is associated with a variety of sociodemographic and health-related factors
Only 340 persons were included in the statistical analyses, as 169 individuals, mainly from the group of short-term users, did not record their intake of benzodiazepines or z-drugs
The standardized daily dose (DDD) is statistically significantly higher than those with guideline-based prescription rate. In both patients group was the medications taken in a lower dose, on average less than one defined daily dose (DDD)
Summary
The long-term use of benzodiazepines (BZD) and z-drugs in older populations is associated with a variety of sociodemographic and health-related factors. Recent studies reported that long-term BZD and z-drugs use is associated with increased age, female sex, and severe negative psychological (e.g., depression) and somatic (e.g., chronic disease) factors. In addition to linking patterns of BZD use to demographic, lifestyle and clinical variables, these studies suggest a positive association of long-term BZD use with alcohol consumption, anxiety and psychological stress; exercise was negatively related to chronic use (Nordfjærn et al, 2013) Psychological factors such as anxiety, depression and addiction behavior are associated with problematic misuse use of BZD and z-drugs (Manthey et al, 2012; Kan, Hilberink & Breteler, 2004; Zandstra et al, 2004). They were more likely to suffer from chronical physical illnesses such as diabetes, asthma, chronic obstructive pulmonary disease, hypertension and serious skin disorders (Zandstra et al, 2002)
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