title: Predicting chronic benzodiazepine use in adults with depressive disorder: Retrospective cohort study using administrative data in Quebec.
abstract: OBJECTIVE
  To identify predictive variables of incident chronic benzodiazepine (BZD) use that could be assessed by prescribing physicians.
  
  
  METHODS
  Retrospective cohort study using public health and drug insurance administrative data.
  
  
  METHODS
  Quebec.
  
  
  METHODS
  New adult BZD users from January 1, 1999, to March 31, 2006, with a diagnosis of depressive disorder in the previous year were included. Chronic BZD use was defined as BZD availability at least 50% of the days between day 181 and day 365 following initiation.
  
  
  METHODS
  Potential associations between chronic BZD use and age; sex; drug insurance status; recent hospitalization; comorbidity; presence of chronic pain; use of psychotropic medication; mental health diagnoses; number, type, and duration of BZDs prescribed; and the prescribing physician's specialty.
  
  
  RESULTS
  Selection led to an exhaustive cohort of 13 688 patients aged 18 to 64 years, and 3683 aged 65 and older. For the 18 to 64 age group, the combination of disability insurance and more than 1 BZD increased the proportion of chronic users from 14.4% to 53.4%. For patients 65 and older, the main correlates of chronic BZD use included claiming more than 1 BZD (adjusted odds ratio 2.24, 99% CI 1.65 to 3.06) and recent hospitalization (adjusted odds ratio 1.70, 99% CI 1.38 to 2.10). Recently hospitalized older patients with a prescription duration of less than 8 days were the highest-risk group identified (57.8%).
  
  
  CONCLUSIONS
  Physicians should be aware that patients are more likely to become chronic BZD users if they receive disability insurance or following a hospitalization. Combination of BZDs is a potentially problematic practice that could be increasing the risk of chronic use.
authors: Psychiatrist and is pursuing a doctoral degree in health sciences research at the University of Sherbrooke, supported by the Clinician Investigator Program of the Royal College of Physicians and Surgeons of Canada.
authors: Jean-Daniel
authors: JD
authors: Carrier
authors: Professor in the family medicine department of the Faculté de médecine et des sciences de la santé at the University of Sherbrooke and a psychology researcher in the PRIMUS (Programme de recherche interdisciplinaire sur la médecine et l'utilisation des soins) research group affiliated with the Centre de recherche du Centre hospitalier universitaire de Sherbrooke.
authors: Pasquale
authors: P
authors: Roberge
authors: Scientific Assistant in the PRIMUS research group.
authors: Josiane
authors: J
authors: Courteau
authors: Clinician-Investigator and Tenured Professor in the family medicine department of the Faculté de médecine et des sciences de la santé at the University of Sherbrooke and Director of the PRIMUS research group. Alain.Vanasse@USherbrooke.ca.
authors: Alain
authors: A
authors: Vanasse
mesh_terms: D000328:Adult; D000368:Aged; D014151:Anti-Anxiety Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001569:Benzodiazepines / Q000008:administration & dosage* / Q000009:adverse effects; D059350:Chronic Pain; D015897:Comorbidity; D003866:Depressive Disorder / Q000188:drug therapy*; D005260:Female; D006760:Hospitalization; D006801:Humans; D018868:Insurance, Disability; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011792:Quebec; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D014151:Anti-Anxiety Agents; D001569:Benzodiazepines