Association of benzodiazepine and Z-drug use with the risk of hospitalisation for fall-related injuries among older people: a nationwide nested case–control study in Taiwan
Abstract Background Non-benzodiazepine hypnotics (Z-drugs) are advocated to be safer than benzodiazepines (BZDs). This study comprehensively investigated the association of BZD and Z-drug usage with the risk of hospitalisation for fall-related injuries in older people. Methods This study used the Ta...
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| Format: | Article |
| Language: | English |
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BMC
2017-07-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12877-017-0530-4 |
| _version_ | 1818275136663453696 |
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| author | Nan-Wen Yu Pei-Jung Chen Hui-Ju Tsai Chih-Wan Huang Yu-Wen Chiu Wen-Ing Tsay Jui Hsu Chia-Ming Chang |
| author_facet | Nan-Wen Yu Pei-Jung Chen Hui-Ju Tsai Chih-Wan Huang Yu-Wen Chiu Wen-Ing Tsay Jui Hsu Chia-Ming Chang |
| author_sort | Nan-Wen Yu |
| collection | DOAJ |
| description | Abstract Background Non-benzodiazepine hypnotics (Z-drugs) are advocated to be safer than benzodiazepines (BZDs). This study comprehensively investigated the association of BZD and Z-drug usage with the risk of hospitalisation for fall-related injuries in older people. Methods This study used the Taiwan National Health Insurance Database with a nested matched case-control design. We identified 2238 elderly patients who had been hospitalised for fall-related injuries between 2003 and 2012. They were individually matched (1:4) with a comparison group by age, sex, and index year. Conditional logistic regression was used to determine independent effects of drug characteristics (type of exposure, dosage, half-life, and polypharmacy) on older people. Results Older people hospitalisation for fall-related injuries were significantly associated with current use of BZDs (adjusted odds ratio [AOR] = 1.32, 95% confidential interval [CI] = 1.17–1.50) and Z-drugs (AOR = 1.24, 95%CI = 1.05–1.48). At all dose levels of BZDs, high dose levels of Z-drugs, long-acting BZD, and short-acting BZD use were all significantly increased the risk of fall-related injuries requiring hospitalisation. Polypharmacy, the use of two or more kinds of BZDs, one kind of BZD plus Z-drugs and two or more kinds of BZDs plus Z-drugs, also significantly increased the risk (AOR = 1.61, 95% CI = 1.38–1.89; AOR = 1.65, 95% CI = 1.08–2.50, and AOR = 1.58, 95% CI = 1.21–2.07). Conclusions Different dose levels and half-lives of BZDs, a high dose of Z-drugs, and polypharmacy with BZDs and Z-drugs were associated with an increased risk of fall-related injury requiring hospitalisation in older people. Physicians should balance the risks and benefits when prescribing these drug regimens to older people considering the risk of falls. |
| first_indexed | 2024-12-12T22:24:57Z |
| format | Article |
| id | doaj.art-34949c3313814437b999764b8dc58a11 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-12T22:24:57Z |
| publishDate | 2017-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-34949c3313814437b999764b8dc58a112022-12-22T00:09:48ZengBMCBMC Geriatrics1471-23182017-07-011711910.1186/s12877-017-0530-4Association of benzodiazepine and Z-drug use with the risk of hospitalisation for fall-related injuries among older people: a nationwide nested case–control study in TaiwanNan-Wen Yu0Pei-Jung Chen1Hui-Ju Tsai2Chih-Wan Huang3Yu-Wen Chiu4Wen-Ing Tsay5Jui Hsu6Chia-Ming Chang7Department of Psychiatry, Chang Gung Memorial Hospital at Linkou and Chang Gung UniversityDepartment of Psychiatry, Chang Gung Memorial Hospital at Linkou and Chang Gung UniversityDepartment of Pediatrics, Feinberg School of Medicine, Northwestern UniversityDepartment of Psychiatry, Chang Gung Memorial Hospital at Linkou and Chang Gung UniversityDepartment of Psychiatry, Chang Gung Memorial Hospital at Linkou and Chang Gung UniversityDivision of Controlled Drugs, Taiwan Food and Drug Administration (TFDA), Ministry of Health and Welfare, Executive YuanDivision of Controlled Drugs, Taiwan Food and Drug Administration (TFDA), Ministry of Health and Welfare, Executive YuanDepartment of Psychiatry, Chang Gung Memorial Hospital at Linkou and Chang Gung UniversityAbstract Background Non-benzodiazepine hypnotics (Z-drugs) are advocated to be safer than benzodiazepines (BZDs). This study comprehensively investigated the association of BZD and Z-drug usage with the risk of hospitalisation for fall-related injuries in older people. Methods This study used the Taiwan National Health Insurance Database with a nested matched case-control design. We identified 2238 elderly patients who had been hospitalised for fall-related injuries between 2003 and 2012. They were individually matched (1:4) with a comparison group by age, sex, and index year. Conditional logistic regression was used to determine independent effects of drug characteristics (type of exposure, dosage, half-life, and polypharmacy) on older people. Results Older people hospitalisation for fall-related injuries were significantly associated with current use of BZDs (adjusted odds ratio [AOR] = 1.32, 95% confidential interval [CI] = 1.17–1.50) and Z-drugs (AOR = 1.24, 95%CI = 1.05–1.48). At all dose levels of BZDs, high dose levels of Z-drugs, long-acting BZD, and short-acting BZD use were all significantly increased the risk of fall-related injuries requiring hospitalisation. Polypharmacy, the use of two or more kinds of BZDs, one kind of BZD plus Z-drugs and two or more kinds of BZDs plus Z-drugs, also significantly increased the risk (AOR = 1.61, 95% CI = 1.38–1.89; AOR = 1.65, 95% CI = 1.08–2.50, and AOR = 1.58, 95% CI = 1.21–2.07). Conclusions Different dose levels and half-lives of BZDs, a high dose of Z-drugs, and polypharmacy with BZDs and Z-drugs were associated with an increased risk of fall-related injury requiring hospitalisation in older people. Physicians should balance the risks and benefits when prescribing these drug regimens to older people considering the risk of falls.http://link.springer.com/article/10.1186/s12877-017-0530-4BenzodiazepineZ-drugsOlder peopleFallHospitalisation |
| spellingShingle | Nan-Wen Yu Pei-Jung Chen Hui-Ju Tsai Chih-Wan Huang Yu-Wen Chiu Wen-Ing Tsay Jui Hsu Chia-Ming Chang Association of benzodiazepine and Z-drug use with the risk of hospitalisation for fall-related injuries among older people: a nationwide nested case–control study in Taiwan BMC Geriatrics Benzodiazepine Z-drugs Older people Fall Hospitalisation |
| title | Association of benzodiazepine and Z-drug use with the risk of hospitalisation for fall-related injuries among older people: a nationwide nested case–control study in Taiwan |
| title_full | Association of benzodiazepine and Z-drug use with the risk of hospitalisation for fall-related injuries among older people: a nationwide nested case–control study in Taiwan |
| title_fullStr | Association of benzodiazepine and Z-drug use with the risk of hospitalisation for fall-related injuries among older people: a nationwide nested case–control study in Taiwan |
| title_full_unstemmed | Association of benzodiazepine and Z-drug use with the risk of hospitalisation for fall-related injuries among older people: a nationwide nested case–control study in Taiwan |
| title_short | Association of benzodiazepine and Z-drug use with the risk of hospitalisation for fall-related injuries among older people: a nationwide nested case–control study in Taiwan |
| title_sort | association of benzodiazepine and z drug use with the risk of hospitalisation for fall related injuries among older people a nationwide nested case control study in taiwan |
| topic | Benzodiazepine Z-drugs Older people Fall Hospitalisation |
| url | http://link.springer.com/article/10.1186/s12877-017-0530-4 |
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