dc.contributor.author | Linnet, Kristjan | |
dc.contributor.author | Sigurdsson, Johann Agust | |
dc.contributor.author | Tomasdottir, Margret Olafia | |
dc.contributor.author | Sigurdsson, Emil Larus | |
dc.contributor.author | Gudmundsson, Lárus S | |
dc.date.accessioned | 2020-02-20T09:22:34Z | |
dc.date.available | 2020-02-20T09:22:34Z | |
dc.date.created | 2020-01-06T11:46:59Z | |
dc.date.issued | 2019 | |
dc.identifier.issn | 2044-6055 | |
dc.identifier.uri | http://hdl.handle.net/11250/2642778 | |
dc.description.abstract | ObjectivesTo assess the risk of mortality in primary care patients, multimorbid (≥2 chronic conditions) or not, prescribed hypnotics/anxiolytics.DesignA longitudinal cohort studysettingPrimary healthcare in the Reykjavik area.Participants114 084 individuals (aged 10–79 years, average 38.5, SD 18.4) contacting general practitioners during 2009–2012 (mortality follow-up to 31 December 2016). Of those, the reference group comprised 58 560 persons who were neither multimorbid nor had redeemed prescriptions for hypnotics/anxiolytics. Participants (16 108) redeeming prescriptions for hypnotics/anxiolytics on a regular basis for 3 consecutive years were considered as consistent, long-term users. They were subdivided into low-dose (1–300 defined daily doses (DDD)/3 years),medium-dose (301–1095 DDDs/3 years) and high-dose users (>1095 DDDs/3 years). All six groups taking these drugs were compared with the reference group.Main outcome measuresAll-cause mortality.resultsHRs were calculated with the no multimorbidity—no drug group as a reference, using Cox proportional hazards regression model adjusting for age, sex and the number of chronic conditions (n=111 767), patients with cancer excluded. During follow-up, 516 358 person-years in total,1926 persons died. Mean follow-up was 1685 days (4.6years), range 1–1826 days (5.0 years). For all multimorbid patients who took no drugs the HR was 1.14 (95% CI 1.00 to 1.30) compared with those without multimorbidity. HRs in the non-multimorbid participants varied from 1.49 to 3.35(95% CI ranging from 1.03 to 4.11) with increasing doses of hypnotics/anxiolytics, and correspondingly from 1.55 to 3.52 (1.18 to 4.29) in multimorbid patients.ConclusionsMortality increased in a dose-dependent manner among both multimorbid and non-multimorbid patients taking hypnotics/anxiolytics. This increase was clearly associated with prescribing of these drugs. Their use should be limited to the recommended period of 2–4 up to 6 weeks; long-term usemay incur increased risk and should be re-examined. | nb_NO |
dc.language.iso | eng | nb_NO |
dc.publisher | BMJ Publishing Group | nb_NO |
dc.relation.uri | https://bmjopen.bmj.com/content/9/12/e033545 | |
dc.rights | Navngivelse-Ikkekommersiell 4.0 Internasjonal | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc/4.0/deed.no | * |
dc.title | Association between prescription of hypnotics/anxiolytics and mortality in multimorbid and non-multimorbid patients: a longitudinal cohort study in primary care. | nb_NO |
dc.type | Journal article | nb_NO |
dc.type | Peer reviewed | nb_NO |
dc.description.version | publishedVersion | nb_NO |
dc.source.volume | 9 | nb_NO |
dc.source.journal | BMJ Open | nb_NO |
dc.identifier.doi | http://dx.doi.org/10.1136/bmjopen-2019-033545 | |
dc.identifier.cristin | 1766728 | |
dc.description.localcode | © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. | nb_NO |
cristin.unitcode | 194,65,20,10 | |
cristin.unitname | Allmennmedisinsk forskningsenhet i Trondheim | |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 1 | |