Health risk appraisal in older people 7: long-acting benzodiazepine use in community-dwelling older adults in London: is it related to physical or psychological factors?

Devoshree Chatterjee, S. Iliffe, K. Kharicha, D. Harari, C. Swift, Gerhard Gillman, A. Stuck
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引用次数: 5

Abstract

Aim To investigate whether the use of long-acting benzodiazepines, in individuals aged 65 and over is mediated by physical or psychological factors. Background Long-acting benzodiazepine consumption among older people has implications for mortality, morbidity and cost-effective prescribing. Two models explain benzodiazepine use in this age group, one linked to physical illness and disability and one to psychological factors. Methods Secondary analysis of baseline data from a study of 1059 community-dwelling non-disabled people aged 65 years and over recruited from three general practices in London. For this analysis, use of long-acting benzodiazepines was defined as any self-reported use of diazepam or nitrazepam in the last four weeks. Associations between demographic factors, health service use, and physical and psychological characteristics and benzodiazepine use were investigated. Findings The prevalence of benzodiazepine use in this sample was 3.3% (35/1059). In univariate analyses, benzodiazepine use was associated with female gender, low income, high consultation rates, physical factors (medication for arthritis or joint pain, polypharmacy, difficulties in instrumental activities of daily living, recent pain) and psychological factors (poor self-perceived health, social isolation, and symptoms of anxiety or agitation). In a multivariate logistic regression analysis only two factors retained statistically significant independent associations with benzodiazepine use: receiving only the state pension (OR=4.0, 95% CI: 1.70, 9.80) and pain in the past four weeks (OR=3.79, 95% CI: 1.36, 10.54).
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老年人健康风险评估7:伦敦社区老年人长效苯二氮卓类药物的使用:与生理或心理因素有关吗?
目的探讨65岁及以上老年人长效苯二氮卓类药物的使用是否与生理或心理因素有关。背景:老年人服用长效苯二氮卓类药物对死亡率、发病率和具有成本效益的处方有影响。有两种模型解释了这个年龄段的苯二氮卓类药物的使用,一种与身体疾病和残疾有关,另一种与心理因素有关。方法对来自伦敦三家全科医院的1059名65岁及以上社区居住的非残疾人士的基线数据进行二次分析。在这项分析中,使用长效苯二氮卓类药物被定义为在过去四周内自我报告使用地西泮或硝西泮。调查了人口因素、卫生服务使用、生理和心理特征与苯二氮卓类药物使用之间的关系。结果本组患者苯二氮卓类药物使用率为3.3%(35/1059)。在单变量分析中,苯二氮卓类药物的使用与女性、低收入、高咨询率、身体因素(治疗关节炎或关节疼痛的药物、多种药物、日常生活工具活动困难、近期疼痛)和心理因素(自我认知健康状况不佳、社会孤立、焦虑或躁动症状)有关。在多变量logistic回归分析中,只有两个因素与苯二氮卓类药物的使用保持有统计学意义的独立关联:仅领取国家养老金(OR=4.0, 95% CI: 1.70, 9.80)和过去四周的疼痛(OR=3.79, 95% CI: 1.36, 10.54)。
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