European journal of clinical pharmacology · 2018
Chronic hypnotic use at 10 years-does the brand matter?
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Schonmann Yochai, Goren Or, Bareket Ronen, Comaneshter Doron, Cohen Arnon D, Vinker Shlomo
Аннотация
PURPOSE: Chronic use of sedative-hypnotics is very common, although not guideline-endorsed. The incidence among new users is not well studied, and there are currently no recommendations favoring any specific agent. We quantified the risk for chronic use in first-time hypnotic users, and the association of the initial choice of hypnotic with later usage patterns.
METHODS: We used the computerized database of Israel's largest healthcare provider. All 236,597 new users of sedative-hypnotics between the years 2000-2005 were followed for 10 years. Filled prescriptions in the second, fifth, and tenth years were recorded. The association of the first hypnotic choice (benzodiazepine/Z-drug) with chronic consumption was assessed using multivariate logistic regression.
RESULTS: Average age on first use was 63.7 (SD ± 16.4) years. 58.6% were women. Benzodiazepines were initiated in 154,929 (65.5%) of the cases. Benzodiazepine users were older and of lower socioeconomic status, compared to Z-drug users (p < 0.001). On the tenth year, 103,912 (66.8%) of new users claimed ≤ 30 DDDs of hypnotics, 3,1724 (20.4%) were long-term users (≥ 180 DDD/year), and 828 (0.5%) used excessively (≥ 720 DDD/year). Z-drugs were associated with an increased risk of long-term use on the second year [17.3% vs. 12.4%, RR = 1.40 (1.37-1.43)] as well as on the fifth [21.9% vs. 13.9%, RR = 1.58 (1.55-1.61)] and tenth year [25.1% vs. 17.7%, RR = 1.42 (1.39-1.45)], p < 0.0001. Similar results were also observed for daily and excessive use (p < 0.001).
CONCLUSIONS: One in five new users of sedative-hypnotics will become a long-term user, but only 0.5% will become excessive users. Z-drugs were associated with an increased risk of chronic use.
METHODS: We used the computerized database of Israel's largest healthcare provider. All 236,597 new users of sedative-hypnotics between the years 2000-2005 were followed for 10 years. Filled prescriptions in the second, fifth, and tenth years were recorded. The association of the first hypnotic choice (benzodiazepine/Z-drug) with chronic consumption was assessed using multivariate logistic regression.
RESULTS: Average age on first use was 63.7 (SD ± 16.4) years. 58.6% were women. Benzodiazepines were initiated in 154,929 (65.5%) of the cases. Benzodiazepine users were older and of lower socioeconomic status, compared to Z-drug users (p < 0.001). On the tenth year, 103,912 (66.8%) of new users claimed ≤ 30 DDDs of hypnotics, 3,1724 (20.4%) were long-term users (≥ 180 DDD/year), and 828 (0.5%) used excessively (≥ 720 DDD/year). Z-drugs were associated with an increased risk of long-term use on the second year [17.3% vs. 12.4%, RR = 1.40 (1.37-1.43)] as well as on the fifth [21.9% vs. 13.9%, RR = 1.58 (1.55-1.61)] and tenth year [25.1% vs. 17.7%, RR = 1.42 (1.39-1.45)], p < 0.0001. Similar results were also observed for daily and excessive use (p < 0.001).
CONCLUSIONS: One in five new users of sedative-hypnotics will become a long-term user, but only 0.5% will become excessive users. Z-drugs were associated with an increased risk of chronic use.