Indicators of Benzodiazepine Use in Nursing Home Residents in France: A Cross-Sectional Study

详细信息    查看全文

• 作者：Philipe de Souto Barreto ; PhD^a ; ^b ; ^{philipebarreto81@yahoo.com} ; Maryse Lapeyre-Mestre ; PhD^c ; ^d ; Cé ; line Mathieu ; MSc^e ; Christine Piau ; MD^f ; Catherine Bouget ; PhD^f ; Franç ; oise Cayla ; MD^e ; Bruno Vellas ; MD ; PhD^a ; ^c ; Yves Rolland ; MD ; PhD^a ; ^c
• 关键词：Psychotropic ; older adults ; nursing home ; dementia
• 刊名：Journal of the American Medical Directors Association
• 出版年：2013
• 出版时间：January, 2013
• 年：2013
• 卷：14
• 期：1
• 页码：29-33
• 全文大小：154 K

文摘

Objectives

Little information is available about associations between nursing home (NH) structural and organizational aspects and benzodiazepine prescriptions, particularly for long-acting drugs. This study addressed this knowledge gap.

Design

Cross-sectional study.

Setting

One hundred seventy-five NHs from France.

Participants

A total of 6275 NH residents, aged 86 years (¡À8.2), and mostly women (73.7 % ).

Measurements

Outcome measures were: (1) benzodiazepine and (2) long-acting benzodiazepine use. NH staff sent to research team all drug prescriptions in the week participants were included in the study; staff also recorded information on residents' characteristics, and NHs structure and internal organization. Binary logistic regressions were performed separately on total and long-acting benzodiazepine.

Results

A total of 3350 persons took benzodiazepine; 577 took long-acting benzodiazepine. Subject-related characteristics were the main correlates of benzodiazepine use. NH characteristics were also related to this outcome: number of beds ¡Ý 91 (Odds Ratio (OR) 0.820, 95 % Confidence Interval (CI) 0.682-0.986), special care unit (OR 1.131, 95 % CI 1.000-1.279), pharmacy for internal usage (OR 1.341, 95 % CI 1.128-1.594), and date records of the first prescription of psychotropics (OR 1.394, 95 % CI 1.209-1.607). Pharmacy for internal usage was also associated with long-acting benzodiazepine (OR 1.374, 95 % CI 1.076-1.754).

Conclusions

NH structure- and organization-related indicators impact benzodiazepine use among NH residents. This finding is of particular importance because these indicators are more easily modifiable than subject-related characteristics. Therefore, NH directors and medical staff should be aware about this to implement feasible modifications for reducing inappropriate and chronic benzodiazepine use.