title: Five-year trajectories of long-term benzodiazepine use by adolescents: patient, provider, and medication factors.
abstract: OBJECTIVE
  This study sought to understand the stability of and change in benzodiazepine use among incident long-term benzodiazepine users over a five-year period and to investigate predictors of variation in use patterns from adolescence into adulthood.
  
  
  METHODS
  Long-term use was defined as receipt of benzodiazepine prescriptions for 31 or more cumulative days in a calendar year. Data for 1999-2005 were obtained from the National Health Insurance Research Database in Taiwan. Two age groups of incident long-term users in 2000 were identified--1,758 aged 12-15 and 5,265 aged 16-19-and their benzodiazepine prescription records from 2001 to 2005 were retrieved. Group-based trajectory analyses and polytomous logistic regression were performed to evaluate differential risk of benzodiazepine use over time.
  
  
  RESULTS
  From 3% to 5% of the incident benzodiazepine users were long-term users. Four distinct groups of users emerged from the five years of study data: occasional, decelerating, accelerating, and chronic users. Overall, one-quarter were accelerating or chronic users. A history of psychosis or epilepsy, prescription by providers from multiple specialties, and receipt of benzodiazepines with a long half-life or mixed indications significantly increased one's risk of becoming a chronic or accelerating user (range of adjusted odds ratios from 2 to 6).
  
  
  CONCLUSIONS
  Patient characteristics and attributes of service providers and pharmacological agents played significant roles in benzodiazepine use patterns. Prescribers can reduce the risk of long-term use by assessing whether pediatric patients have received benzodiazepines from multiple doctors for various medical conditions.
authors.affiliation: Division of Mental Health and Addiction Medicine, National Health Research Institutes, Miaoli, Taiwan.
authors.forename: Hsueh-Han
authors.initials: HH
authors.lastname: Yeh
authors.forename: Chuan-Yu
authors.initials: CY
authors.lastname: Chen
authors.forename: Shao-You
authors.initials: SY
authors.lastname: Fang
authors.forename: I-Shou
authors.initials: IS
authors.lastname: Chang
authors.forename: Erin Chia-Hsuan
authors.initials: EC
authors.lastname: Wu
authors.forename: Keh-Ming
authors.initials: KM
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001569:Benzodiazepines / Q000008:administration & dosage / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D002648:Child; D006801:Humans; D007348:Insurance, Health; D016015:Logistic Models; D001523:Mental Disorders / Q000188:drug therapy; D012042:Registries; D012959:Socioeconomic Factors; D013624:Taiwan; D013997:Time Factors; D055815:Young Adult
chemical_list: D001569:Benzodiazepines