Journal of General Internal Medicine

, Volume 22, Issue 7, pp 1024–1029

Initiation of Benzodiazepines in the Elderly After Hospitalization

  • Chaim M. Bell
  • Hadas D. Fischer
  • Sudeep S. Gill
  • Brandon Zagorski
  • Kathy Sykora
  • Walter P. Wodchis
  • Nathan Herrmann
  • Susan E. Bronskill
  • Phil E. Lee
  • Geoff M. Anderson
  • Paula A. Rochon
Hospital Medicine

DOI: 10.1007/s11606-007-0194-4

Cite this article as:
Bell, C.M., Fischer, H.D., Gill, S.S. et al. J GEN INTERN MED (2007) 22: 1024. doi:10.1007/s11606-007-0194-4

Abstract

Objective

To estimate the rate of new chronic benzodiazepine use after hospitalization in older adults not previously prescribed with benzodiazepines.

Design

Retrospective cohort study using linked, population-based administrative data.

Setting

Ontario, Canada between April 1, 1992 and March 31, 2005.

Participants

Community-dwelling seniors who had not been prescribed benzodiazepine drugs in the year before hospitalization were selected from all 1.4 million Ontario residents aged 66 years and older.

Main Outcome Measures

New chronic benzodiazepine users, defined as initiation of benzodiazepines within 7 days after hospital discharge and an additional claim within 8 days to 6 months. We used multivariate logistic regression to examine for the effect of hospitalization on the primary outcome after adjusting for confounders.

Results

There were 405,128 patient hospitalizations included in the cohort. Benzodiazepines were prescribed to 12,484 (3.1%) patients within 7 days of being discharged from hospital. A total of 6,136 (1.5%) patients were identified as new chronic benzodiazepine users. The rate of new chronic benzodiazepine users decreased over the study period from 1.8% in the first year to 1.2% in the final year (P < .001). Multivariate logistic regression found that women, patients admitted to the intensive care unit or nonsurgical wards, those with longer hospital stays, higher overall comorbidity, a prior diagnosis of alcoholism, and those prescribed more medications had significantly elevated adjusted odds ratios for new chronic benzodiazepine users. Older individuals had a lower risk for the primary outcome.

Conclusion

New benzodiazepine prescription after hospitalization occurs frequently in older adults and may result in chronic use. A systemic effort to address this risky practice should be considered.

KEY WORDS

benzodiazepine initiationelderlyposthospitalization

Copyright information

© Society of General Internal Medicine 2007

Authors and Affiliations

  • Chaim M. Bell
    • 1
    • 2
    • 3
    • 4
  • Hadas D. Fischer
    • 2
  • Sudeep S. Gill
    • 2
    • 5
  • Brandon Zagorski
    • 2
  • Kathy Sykora
    • 2
  • Walter P. Wodchis
    • 2
    • 4
    • 6
  • Nathan Herrmann
    • 7
  • Susan E. Bronskill
    • 2
    • 4
  • Phil E. Lee
    • 8
  • Geoff M. Anderson
    • 2
    • 4
  • Paula A. Rochon
    • 2
    • 3
    • 4
    • 9
  1. 1.Department of MedicineSt. Michael’s HospitalTorontoCanada
  2. 2.Institute for Clinical Evaluative SciencesTorontoCanada
  3. 3.Department of MedicineUniversity of TorontoTorontoCanada
  4. 4.Department of Health Policy Management and EvaluationUniversity of TorontoTorontoCanada
  5. 5.Department of MedicineQueen’s UniversityKingstonCanada
  6. 6.Toronto Rehabilitation InstituteTorontoCanada
  7. 7.Department of PsychiatryUniversity of TorontoTorontoCanada
  8. 8.Department of MedicineUniversity of British ColumbiaVancouverCanada
  9. 9.Kunin-Lunenfeld Applied Research Unit, BaycrestTorontoCanada