Hospital initiation of benzodiazepines and Z-drugs in older adults and discontinuation in primary care
| Autor: | Frank Moriarty, Tom Fahey, Mary E Walsh, Seán Coll |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Pharmaceutical Science Pharmacy Primary care Benzodiazepines 03 medical and health sciences 0302 clinical medicine Patient age Hospital discharge Humans Medicine 030212 general & internal medicine Medical prescription Discharge summary Aged Retrospective Studies business.industry Hazard ratio Retrospective cohort study After discharge Hospitals Patient Discharge Discontinuation Prescriptions Emergency medicine Deprescribing business 030217 neurology & neurosurgery Cohort study |
| Zdroj: | Research in Social and Administrative Pharmacy. 18:2670-2674 |
| ISSN: | 1551-7411 |
| DOI: | 10.1016/j.sapharm.2021.06.001 |
| Popis: | ObjectiveTo examine factors associated with continuation of hospital-initiated benzodiazepine receptor agonists (BZRAs) among adults aged ≥65 years, specifically instructions on hospital discharge summaries.MethodsThis 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.ResultsMost BZRA initiations occurred in primary care, however the rate of hospital-initiated BZRAs was higher. Almost 60% of 418 hospital initiations had some BZRA instructions (e.g. duration) on the discharge summary. 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 1.67, 95%CI 1.09-2.55).ConclusionsImproved communication to GPs after hospital discharge may be important in avoiding long-term BZRA use. |
| Databáze: | OpenAIRE |
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