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Patterns, predictors and persistence of chronic sedative use: a population-based observational study of older adults in British Columbia, Canada

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Background

Benzodiazepines and benzodiazepine-like sedatives (zopiclone, zolpidem and zaleplon) are commonly prescribed to treat anxiety and insomnia but are contraindicated for chronic use. We sought to study the persistence, over multiple years, of chronic use of benzodiazepines and benzodiazepine-like sedatives among community-dwelling adults in British Columbia, Canada.

Methods

This is a retrospective analysis of linked health data for adults aged 50 to 69 in 2004 who resided in British Columbia, Canada, between 2004 and 2013. We assigned subjects to one of four groups according to the total number of days of benzodiazepines and benzodiazepine-like sedatives that they were dispensed from retail pharmacies in each observation year. We estimated logistic regression models to measure associations between the odds of chronic sedative use and explanatory variables. We computed transition probability matrices that depict likelihood of changes in sedative utilization levels across years.

Results

Nearly one in ten (9.4%) community-dwelling older adults in British Columbia filled prescriptions with more than 90 days’ worth of benzodiazepines or benzodiazepine-like sedatives in 2013. The odds of such chronic sedative use were higher for people who were older, had lower income, were sicker, or lived in rural communities; odds were lower for people with Chinese or South Asian surnames and for men who were married. Controlling for other factors, chronic users of sedatives in 2008 were 15 times more likely than non-users of sedatives in 2008 to be chronic sedative users in 2013 (OR = 14.73; 95% CI = [14.24, 15.24]). Approximately two out of every five older British Columbians who were chronic sedative users in 2013 had been chronic users of sedatives 10 years prior. Two out of every three chronic sedative users in 2004 were either chronic users (57%) or dead (16%) by 2013.

Interpretation

Chronic use of sedatives is prevalent and persistent among older adults in British Columbia. The persistence of chronic sedative use between when patients were 50 to 59 years old and when they were 60 to 69 years old suggests that earlier interventions to curb chronic sedative use may be warranted even if patients do not experience significant risks until later ages.

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Author information

Authors and Affiliations

  1. School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T1Z3, Canada

    Steven G. Morgan

  2. British Columbia Cancer Agency, Canadian Centre for Applied Research in Cancer Control, 675 W 10th Ave, Vancouver, BC, V5Z 1L3, Canada

    Deirdre Weymann

Authors
  1. Steven G. Morgan
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Contributions

SM was responsible for project conception, acquisition of funding and data, study design, assisting with the interpretation of results and drafting of the manuscript. DW was responsible for data analysis, drafting sections of the manuscript and revising the manuscript for important intellectual content. All authors gave final approval of the version to be published and agreed to act as guarantors of the work.

Corresponding author

Correspondence to Steven G. Morgan.

Ethics declarations

Ethics approval

The University of British Columbia’s Behavioural Research Ethics Board approved this study.

Competing interests

The declare authors that they have no competing interests.

Funding

This study was funded by the Canadian Institutes of Health Research. The funding body was not involved in the study design, analysis, interpretation of the data or writing of this manuscript.

Disclaimer

All inferences, opinions and conclusions drawn in this report are those of the authors and do not reflect the opinions or policies of Population Data BC or the data stewards.

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Morgan, S.G., Weymann, D. Patterns, predictors and persistence of chronic sedative use: a population-based observational study of older adults in British Columbia, Canada. Eur J Clin Pharmacol 73, 1001–1008 (2017). https://doi.org/10.1007/s00228-017-2253-z

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  • DOI: https://doi.org/10.1007/s00228-017-2253-z

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