Mayer-Oakes S A, Kelman G, Beers M H, De Jong F, Matthias R, Atchison K A, Lubben J E, Schweitzer S O
Hospital Based Home Care, Los Angeles, CA.
Ann Pharmacother. 1993 Apr;27(4):416-21. doi: 10.1177/106002809302700403.
To determine the use of benzodiazepines (BZDs) in an older, community-dwelling sample and to examine the sociodemographic and clinical correlates of BZD use.
A cross-sectional study of 1752 elderly people (aged > or = 65 y) who completed a mailed medication survey and a telephone health status survey.
Participants were invited to participate in a large Medicare demonstration project on prevention by their private physicians, who were also enrolled in the larger study. Participants had to be English-speaking, could not have dementia or a terminal illness, and had to give informed consent to participate in the study.
Sociodemographic and health status variables that predicted BZD use were examined. Sociodemographic variables included age, gender, ethnicity, education, and income. Health status variables included functional status, with measures of mental, social, and physical health. Influenza immunization status was used as an indicator for preventive health services use and self-reported chronic illness was used as a measure of comorbidity.
Twenty percent of the participants used BZDs at least twice in the past year. We found that those who used BZDs were more than twice as likely to take ten or more drugs, two-and-a-half times more likely to have difficulty falling asleep, and over twice as likely to be depressed. BZD users were also more likely to be white, to have a college education, and to have received a recent influenza shot, but were not more likely to be women when controlled for health status.
Further clinical research should explore the relationship between BZD use among older patients and the BZD-associated adverse clinical factors we observed, as well as the association between multiple drug use and potential adverse outcomes in older BZD users.
确定苯二氮䓬类药物(BZD)在老年社区居民样本中的使用情况,并研究使用BZD的社会人口学和临床相关因素。
对1752名老年人(年龄≥65岁)进行的横断面研究,这些老年人完成了邮寄的用药调查问卷和电话健康状况调查。
参与者由其私人医生邀请参加一项关于预防的大型医疗保险示范项目,这些医生也参与了更大规模的研究。参与者必须说英语,不能患有痴呆症或绝症,并且必须给予知情同意才能参与研究。
研究预测BZD使用情况的社会人口学和健康状况变量。社会人口学变量包括年龄、性别、种族、教育程度和收入。健康状况变量包括功能状态,以及心理、社会和身体健康指标。流感疫苗接种状况用作预防性健康服务使用情况的指标,自我报告的慢性病用作合并症的衡量指标。
20%的参与者在过去一年中至少使用过两次BZD。我们发现,使用BZD的人服用十种或更多药物的可能性是其他人的两倍多,难以入睡的可能性是其他人的2.5倍,抑郁的可能性是其他人的两倍多。BZD使用者也更有可能是白人、拥有大学学历且最近接种过流感疫苗,但在控制健康状况后,女性使用BZD的可能性并不更高。
进一步的临床研究应探讨老年患者使用BZD与我们观察到的BZD相关不良临床因素之间的关系,以及老年BZD使用者中多种药物使用与潜在不良后果之间的关联。