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Patient Characteristics and Practice Variation Associated With New Community Prescription of Benzodiazepine and z-Drug Hypnotics After Critical Illness: A Retrospective Cohort Study Using the UK Clinical Practice Research Datalink. | LitMetric

AI Article Synopsis

  • Survivors of critical illness often develop mental health issues and sleep disorders, leading to the study of new benzodiazepine and z-drug prescriptions among these individuals.
  • A retrospective study analyzed data from over 52,000 adult survivors who didn't use these medications before hospitalization, finding that 5.2% received a new prescription within 90 days post-discharge and 2.5% had persistent use.
  • Key factors associated with new prescriptions included a history of insomnia, anxiety, depression, and recent opioid use, while sex didn't impact prescribing rates and older patients were less likely to be prescribed these medications.

Article Abstract

Purpose: Survivors of critical illness are often affected by new or worsened mental health conditions and sleep disorders. We examined the incidence, practice variation and factors associated with new benzodiazepine and z-drug community prescriptions among critical illness survivors.

Methods: A retrospective cohort study using the UK Clinical Practice Research Datalink data included 52 846 adult critical care survivors hospitalised in 2010 and 2018 who were not prescribed benzodiazepines or z-drugs before hospitalisation. We performed multilevel multivariable logistic regression to assess patient factors associated with new (any prescription within 90 days) and with new-and-persistent (2+ prescriptions within 180 days) benzodiazepine or z-drug prescribing, and to evaluate variation by primary care practice.

Results: 5.2% (2769/52846) of treatment-naïve survivors (95% CI 5.1-5.4) were prescribed a benzodiazepine or z-drug, and 2.5% (1311/52846) had new-and-persistent prescribing. A history of insomnia (adjusted OR 1.96; 95% CI 1.74-2.21), anxiety or depression (adjusted OR 1.40; 95% CI 1.28-1.53) and recent prescription opioid use (adjusted OR 1.47; 95% CI 1.34-1.61) were associated with new community prescription. Sex was not associated with new prescriptions and older patients were less likely to receive a prescription. 2.6% of the variation in new prescribing and 4.1% of the variation in new-and-persistent prescribing were attributable to the prescribing practice.

Conclusions: One in twenty critical illness survivors receive a new community benzodiazepine or z-drug prescription. Further research is needed to understand where in the patient care pathway initiation occurs and the risk of adverse events in survivors of recent critical illness.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11602247PMC
http://dx.doi.org/10.1002/pds.70056DOI Listing

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