title: Indicators of benzodiazepine use in nursing home residents in France: a cross-sectional study.
abstract: OBJECTIVE
  Little information is available about associations between nursing home (NH) structural and organizational aspects and benzodiazepine prescriptions, particularly for long-acting drugs. This study addressed this knowledge gap.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  One hundred seventy-five NHs from France.
  
  
  METHODS
  A total of 6275 NH residents, aged 86 years (± 8.2), and mostly women (73.7%).
  
  
  METHODS
  Outcome measures were: (1) benzodiazepine and (2) long-acting benzodiazepine use. NH staff sent to research team all drug prescriptions in the week participants were included in the study; staff also recorded information on residents' characteristics, and NHs structure and internal organization. Binary logistic regressions were performed separately on total and long-acting benzodiazepine.
  
  
  RESULTS
  A total of 3350 persons took benzodiazepine; 577 took long-acting benzodiazepine. Subject-related characteristics were the main correlates of benzodiazepine use. NH characteristics were also related to this outcome: number of beds ≥ 91 (Odds Ratio (OR) 0.820, 95% Confidence Interval (CI) 0.682-0.986), special care unit (OR 1.131, 95% CI 1.000-1.279), pharmacy for internal usage (OR 1.341, 95%CI 1.128-1.594), and date records of the first prescription of psychotropics (OR 1.394, 95% CI 1.209-1.607). Pharmacy for internal usage was also associated with long-acting benzodiazepine (OR 1.374, 95% CI 1.076-1.754).
  
  
  CONCLUSIONS
  NH structure- and organization-related indicators impact benzodiazepine use among NH residents. This finding is of particular importance because these indicators are more easily modifiable than subject-related characteristics. Therefore, NH directors and medical staff should be aware about this to implement feasible modifications for reducing inappropriate and chronic benzodiazepine use.
authors.affiliation: Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), Toulouse, France. philipebarreto81@yahoo.com
authors.forename: Philipe
authors.initials: P
authors.lastname: de Souto Barreto
authors.forename: Maryse
authors.initials: M
authors.lastname: Lapeyre-Mestre
authors.forename: Céline
authors.initials: C
authors.lastname: Mathieu
authors.forename: Christine
authors.initials: C
authors.lastname: Piau
authors.forename: Catherine
authors.initials: C
authors.lastname: Bouget
authors.forename: Françoise
authors.initials: F
authors.lastname: Cayla
authors.forename: Bruno
authors.initials: B
authors.lastname: Vellas
authors.forename: Yves
authors.initials: Y
authors.lastname: Rolland
mesh_terms: D000203:Activities of Daily Living; D000369:Aged, 80 and over; D001569:Benzodiazepines / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D005602:France; D006801:Humans; D057970:Inappropriate Prescribing; D016015:Logistic Models; D008297:Male; D009735:Nursing Homes; D019338:Polypharmacy; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*
chemical_list: D001569:Benzodiazepines