Coll, Seán and Walsh, Mary E and Fahey, Tom and Moriarty, Frank (2022) Hospital initiation of benzodiazepines and Z-drugs in older adults and discontinuation in primary care. Research in Social & Administrative Pharmacy, 18, (4), pp. 2670-2674. doi: 10.1016/j.sapharm.2021.06.001.
External website: https://www.sciencedirect.com/science/article/pii/...
OBJECTIVE: To examine factors associated with continuation of hospital-initiated benzodiazepine receptor agonists (BZRAs) among adults aged ≥65 years, specifically instructions on hospital discharge summaries.
METHODS: This retrospective cohort study involved anonymised electronic record data on prescribing and hospitalisations for 38,229 patients aged ≥65 from forty-four GP practices in Ireland 2011-2016. BZRA initiations were identified among patients with no BZRA prescription in the previous 12 months. Multivariate regression examined whether instructions on discharge messages for hospital-initiated BZRA prescriptions was associated with continuation after discharge in primary care and time to discontinuation.
RESULTS: In total, 418 hospital-initiated BZRAs were identified, 48.8% being to males and mean patient age was 79.0 (SD 8.3) years. Almost 60% of these discharge summarieshad some BZRA instructions (e.g. duration). Approximately 40% (n = 166) were continued in primary care. Lower age, being prescribed a Z-drug or great number of medicines were associated with higher risk of continuation. Of those continued in primary care, in 98 cases (59.6%) the BZRA was discontinued during follow-up (after a mean 184 days). Presence of instructions was associated with higher likelihood of discontinuation (hazard ratio 1.71, 95%CI 1.11-2.62).
CONCLUSIONS: Improved communication to GPs after hospital discharge may be important in avoiding long-term BZRA use.
B Substances > New (novel) psychoactive substances > Other novel substances > Zopiclone, eszopiclone, zaleplon and zolpidem
E Concepts in biomedical areas > Medical substance > Prescription drug (medicine / medication)
J Health care, prevention, harm reduction and treatment > Prevention approach > Prevention through information and education
J Health care, prevention, harm reduction and treatment > Patient / client care management
J Health care, prevention, harm reduction and treatment > Health care programme, service or facility > Hospital
J Health care, prevention, harm reduction and treatment > Health care programme, service or facility > Community-based treatment (primary care)
T Demographic characteristics > Elderly / Older person
T Demographic characteristics > Doctor / physician
VA Geographic area > Europe > Ireland
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