Correlates of (inappropriate) benzodiazepine use: the Netherlands Study of Depression and Anxiety (NESDA)
- 10 January 2011
- journal article
- Published by Wiley in British Journal of Clinical Pharmacology
- Vol. 71 (2), 263-272
- https://doi.org/10.1111/j.1365-2125.2010.03818.x
Abstract
Results on determinants of benzodiazepine (BZD) use in general and inappropriate use were inconsistent and mostly univariate. The relative importance of sociodemographic, psychological and physical determinants has never been investigated in a comprehensive, multivariate model. We included 429 BZD users and 2423 non-users from the Netherlands Study of Depression and Anxiety (NESDA) in order to investigate sociodemographic, psychological and physical determinants of BZD use and inappropriate use by logistic and linear regression analyses. BZDs were used by a considerable proportion of the 2852 NESDA participants (15.0%). BZD use was independently associated with older age, singleness, unemployment, treatment in secondary care, higher medical consumption (more severe) anxiety, depression (OR [95% CI]=1.95 [1.29, 2.93]), comorbidity, insomnia, SSRI (OR [95% CI]=2.05 [1.55, 2.70]), TCA and other antidepressant (OR [95% CI]=2.44 [1.64, 3.62]) use. Overall, BZD use was rarely in accordance with all guidelines, mainly because most users (82.5%) exceeded the recommended duration of safe use. Inappropriate use was independently associated with older age (β=0.130) and chronic illnesses (β=0.120). Higher scores on agreeableness were associated with less inappropriate use. Mentally or physically vulnerable subjects were most likely to use BZDs. The most vulnerable (i.e. the old and physically ill) BZD users were at highest risk of inappropriate BZD use. Without further evidence of the effectiveness of BZDs in long-term use, caution in initiating BZD prescriptions is recommended, particularly when patients are chronically ill and old, as those are most likely to display inappropriate use.This publication has 59 references indexed in Scilit:
- The structure and dimensionality of the Inventory of Depressive Symptomatology Self Report (IDS-SR) in patients with depressive disorders and healthy controlsJournal of Affective Disorders, 2010
- Determinants of chronic benzodiazepine use in the elderly: A longitudinal studyBritish Journal of Clinical Pharmacology, 2007
- Quality of life and benzodiazepine drug use by community-dwelling elderly: a stress and coping perspectiveEuropean Review of Applied Psychology, 2007
- Physicians’ Perspectives on Prescribing Benzodiazepines for Older Adults: A Qualitative StudyJournal of General Internal Medicine, 2007
- The role of coping strategies in protecting individuals against long‐term tranquillizer usePsychology and Psychotherapy: Theory, Research and Practice, 1996
- Benzodiazepines in primary health care: a survey of general practitioners prescribing patternsAddiction, 1996
- Use of benzodiazepines in the communityArchives of Internal Medicine, 1994
- Factors Linked to the Prescribing of Benzodiazepines by General Practice Principals and TraineesFamily Practice, 1992
- Grading the severity of chronic painPain, 1992
- Prevalence and correlates of the long-term regular use of anxiolyticsJAMA, 1984