The prevalence and prescribing patterns of benzodiazepines and Z-drugs in older nursing home residents in different European countries and Israel: retrospective results from the EU SHELTER study
Abstract Background Benzodiazepines (BZDs) and Z-drugs have high potential for developing frequent adverse drug events in older adults (e.g., psychomotor sedation, drug-related dementia, deliria, drug dependence, etc.). Knowledge of the prevalence and patterns of the use of BZDs/Z-drugs in vulnerabl...
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doaj-37bf7b9873b1499b84fb4a2cbcd7d5cb2021-05-02T11:11:39ZengBMCBMC Geriatrics1471-23182021-04-0121111610.1186/s12877-021-02213-xThe prevalence and prescribing patterns of benzodiazepines and Z-drugs in older nursing home residents in different European countries and Israel: retrospective results from the EU SHELTER studyAnna Lukačišinová0Daniela Fialová1Nancye May Peel2Ruth Eleanor Hubbard3Jovana Brkic4Graziano Onder5Eva Topinková6Jacob Gindin7Tamar Shochat8Leonard Gray9Roberto Bernabei10Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles UniversityDepartment of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles UniversityCentre for Health Services Research, The University of QueenslandCentre for Health Services Research, The University of QueenslandDepartment of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles UniversityDepartment of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di SanitàDepartment of Geriatrics, 1st Faculty of Medicine, Charles UniversityThe Center for Standards in Health and Disability, The University of HaifaThe Cheryl Spencer Department of Nursing, The University of HaifaCentre for Health Services Research, The University of QueenslandCentro Medicina dell’Invecchiamento, Dipartimento di Scienze Gerontologiche, Geriatriche e Fisiatriche, Universita Cattolica Sacro CuoreAbstract Background Benzodiazepines (BZDs) and Z-drugs have high potential for developing frequent adverse drug events in older adults (e.g., psychomotor sedation, drug-related dementia, deliria, drug dependence, etc.). Knowledge of the prevalence and patterns of the use of BZDs/Z-drugs in vulnerable older patients is important in order to prevent and reduce the burden caused by their drug-related complications. Our study focused on international comparisons of the prevalence, country-specific prescribing patterns and risk factors of regular BZD/Z-drug use in nursing home (NH) residents. Methods This cross-sectional study retrospectively analysed data of 4156 NH residents, prospectively assessed in the Services and Health in the Elderly in Long TERm care (SHELTER) project conducted from 2009 to 2014. Residents aged 65+ in 57 NHs in 7 European countries and Israel were assessed by the InterRAI Long-Term Care Facilities instrument. Descriptive statistics and multiple logistic regression models were used to describe the country-specific prevalence, patterns and risk factors of BZD/Z-drug use. Results The mean age of the participants was 83.4 ± 9.4 years, 73% were female and 27.7% used BZDs/Z-drugs. The prevalence of BZD/Z-drug use differed significantly across countries, ranging from 44.1% in Israel to 14.5% in Germany. The most frequently prescribed were zopiclone (17.8%), lorazepam (17.1%) and oxazepam (16.3%). Lorazepam, oxazepam and diazepam were used in most of the countries. Brotizolam, temazepam and zolpidem showed highest prevalence in Israel (99.4% of all regular users of this medication in the sample), the Netherlands (72.6%) and France (50.0%), respectively. Residing in Israel was the most significant factor associated with the use of BZDs/Z-drugs or BZDs only (odds ratio [OR] 6.7; 95% confidence interval [CI] 4.8–9.2 and OR 9.7, 95%CI 6.5–14.5, respectively). The use of Z-drugs only was most significantly associated with residing in France (OR 21.0, 95%CI 9.0–48.9). Conclusions Despite global recommendations and warnings, the preference for and extent of use of individual BZDs and Z-drugs in vulnerable NH residents differ significantly across countries. The strong association with country of residence compared to clinical and functional factors denotes that prescribing habits, social, cultural, behavioural, and regulatory factors still play an important role in the current diverse use of these medications.https://doi.org/10.1186/s12877-021-02213-xBenzodiazepinesZ-drugsNursing homesEuropeIsraelAged |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Anna Lukačišinová Daniela Fialová Nancye May Peel Ruth Eleanor Hubbard Jovana Brkic Graziano Onder Eva Topinková Jacob Gindin Tamar Shochat Leonard Gray Roberto Bernabei |
spellingShingle |
Anna Lukačišinová Daniela Fialová Nancye May Peel Ruth Eleanor Hubbard Jovana Brkic Graziano Onder Eva Topinková Jacob Gindin Tamar Shochat Leonard Gray Roberto Bernabei The prevalence and prescribing patterns of benzodiazepines and Z-drugs in older nursing home residents in different European countries and Israel: retrospective results from the EU SHELTER study BMC Geriatrics Benzodiazepines Z-drugs Nursing homes Europe Israel Aged |
author_facet |
Anna Lukačišinová Daniela Fialová Nancye May Peel Ruth Eleanor Hubbard Jovana Brkic Graziano Onder Eva Topinková Jacob Gindin Tamar Shochat Leonard Gray Roberto Bernabei |
author_sort |
Anna Lukačišinová |
title |
The prevalence and prescribing patterns of benzodiazepines and Z-drugs in older nursing home residents in different European countries and Israel: retrospective results from the EU SHELTER study |
title_short |
The prevalence and prescribing patterns of benzodiazepines and Z-drugs in older nursing home residents in different European countries and Israel: retrospective results from the EU SHELTER study |
title_full |
The prevalence and prescribing patterns of benzodiazepines and Z-drugs in older nursing home residents in different European countries and Israel: retrospective results from the EU SHELTER study |
title_fullStr |
The prevalence and prescribing patterns of benzodiazepines and Z-drugs in older nursing home residents in different European countries and Israel: retrospective results from the EU SHELTER study |
title_full_unstemmed |
The prevalence and prescribing patterns of benzodiazepines and Z-drugs in older nursing home residents in different European countries and Israel: retrospective results from the EU SHELTER study |
title_sort |
prevalence and prescribing patterns of benzodiazepines and z-drugs in older nursing home residents in different european countries and israel: retrospective results from the eu shelter study |
publisher |
BMC |
series |
BMC Geriatrics |
issn |
1471-2318 |
publishDate |
2021-04-01 |
description |
Abstract Background Benzodiazepines (BZDs) and Z-drugs have high potential for developing frequent adverse drug events in older adults (e.g., psychomotor sedation, drug-related dementia, deliria, drug dependence, etc.). Knowledge of the prevalence and patterns of the use of BZDs/Z-drugs in vulnerable older patients is important in order to prevent and reduce the burden caused by their drug-related complications. Our study focused on international comparisons of the prevalence, country-specific prescribing patterns and risk factors of regular BZD/Z-drug use in nursing home (NH) residents. Methods This cross-sectional study retrospectively analysed data of 4156 NH residents, prospectively assessed in the Services and Health in the Elderly in Long TERm care (SHELTER) project conducted from 2009 to 2014. Residents aged 65+ in 57 NHs in 7 European countries and Israel were assessed by the InterRAI Long-Term Care Facilities instrument. Descriptive statistics and multiple logistic regression models were used to describe the country-specific prevalence, patterns and risk factors of BZD/Z-drug use. Results The mean age of the participants was 83.4 ± 9.4 years, 73% were female and 27.7% used BZDs/Z-drugs. The prevalence of BZD/Z-drug use differed significantly across countries, ranging from 44.1% in Israel to 14.5% in Germany. The most frequently prescribed were zopiclone (17.8%), lorazepam (17.1%) and oxazepam (16.3%). Lorazepam, oxazepam and diazepam were used in most of the countries. Brotizolam, temazepam and zolpidem showed highest prevalence in Israel (99.4% of all regular users of this medication in the sample), the Netherlands (72.6%) and France (50.0%), respectively. Residing in Israel was the most significant factor associated with the use of BZDs/Z-drugs or BZDs only (odds ratio [OR] 6.7; 95% confidence interval [CI] 4.8–9.2 and OR 9.7, 95%CI 6.5–14.5, respectively). The use of Z-drugs only was most significantly associated with residing in France (OR 21.0, 95%CI 9.0–48.9). Conclusions Despite global recommendations and warnings, the preference for and extent of use of individual BZDs and Z-drugs in vulnerable NH residents differ significantly across countries. The strong association with country of residence compared to clinical and functional factors denotes that prescribing habits, social, cultural, behavioural, and regulatory factors still play an important role in the current diverse use of these medications. |
topic |
Benzodiazepines Z-drugs Nursing homes Europe Israel Aged |
url |
https://doi.org/10.1186/s12877-021-02213-x |
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