title: Benzodiazepine pathways in the chronically ill.
abstract: The association between patterns of use of benzodiazepines and chronic somatic morbidity was examined by applying the Chronic Disease Score (CDS). In the only pharmacy in a Dutch community, 6921 patients with data available covering a 10-year period (1983-1992) were included. In 1992, two-thirds of the patients had a CDS of 0, indicating no chronic morbidity. Patients with chronic morbidity showed a twofold risk of a history of benzodiazepine use. Within the group of benzodiazepine users, longer exposure to benzodiazepines as well as a history of different benzodiazepines were associated with a higher risk of chronic morbidity. Duration of episodes of use and daily dose were not found to be significantly associated with chronic disease. A pattern of increased benzodiazepine use showed a higher risk of chronic morbidity compared with benzodiazepine users with a stable use. Moreover, a history of benzodiazepine use was found to predict a sharp increase in chronic morbidity. We found a clear association between previous and actual use of benzodiazepines and chronic somatic disease. Benzodiazepine use may be induced by sleeping difficulties and anxiety problems caused by the chronic disease.
authors.affiliation: Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Van Hulten
authors.forename: E R
authors.initials: ER
authors.lastname: Heerdink
authors.forename: A
authors.initials: A
authors.lastname: Bakker
authors.forename: H G
authors.initials: HG
authors.lastname: Leufkens