Evidence map›Paper›PMID 24647164›Full record

ArticleBMJ (Clinical research ed.)2014

Effect of anxiolytic and hypnotic drug prescriptions on mortality hazards: retrospective cohort study.

Scott Weich, Hannah Louise Pearce, Peter Croft, Swaran Singh, Ilana Crome, James Bashford, Martin Frisher

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ (Clinical research ed.), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 107 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
107citing papers in PubMed, 6 pooled it
19.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

107 citing papers in PubMed, 6 syntheses or guidelines pooled it, 250 citations in OpenAlex.

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  7. The DREAMS START intervention for sleep in dementia: Long-term follow-up of a randomized controlled trial.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
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  12. Efficacy of two interventions on the discontinuation of benzodiazepines in long-term users: 36-month follow-up of a cluster randomised trial in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2016
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47 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Scott WeichDivision of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, West Midlands CV4 7AL, UK.
Hannah Louise Pearce
Peter Croft
Swaran Singh
Ilana Crome
James Bashford
Martin Frisher
Keele University · GBUniversity of Warwick · GBSt George's Hospital · GB

Funding

Medical Research Council
6 · The paper itself

Abstract

objectiveTo test the hypothesis that people taking anxiolytic and hypnotic drugs are at increased risk of premature mortality, using primary care prescription records and after adjusting for a wide range of potential confounders.

designRetrospective cohort study.

setting273 UK primary care practices contributing data to the General Practice Research Database.

participants34,727 patients aged 16 years and older first prescribed anxiolytic or hypnotic drugs, or both, between 1998 and 2001, and 69,418 patients with no prescriptions for such drugs (controls) matched by age, sex, and practice. Patients were followed-up for a mean of 7.6 years (range 0.1-13.4 years). MAIN OUTCOME: All cause mortality ascertained from practice records.

resultsPhysical and psychiatric comorbidities and prescribing of non-study drugs were significantly more prevalent among those prescribed study drugs than among controls. The age adjusted hazard ratio for mortality during the whole follow-up period for use of any study drug in the first year after recruitment was 3.46 (95% confidence interval 3.34 to 3.59) and 3.32 (3.19 to 3.45) after adjusting for other potential confounders. Dose-response associations were found for all three classes of study drugs (benzodiazepines, Z drugs (zaleplon, zolpidem, and zopiclone), and other drugs). After excluding deaths in the first year, there were approximately four excess deaths linked to drug use per 100 people followed for an average of 7.6 years after their first prescription.

conclusionsIn this large cohort of patients attending UK primary care, anxiolytic and hypnotic drugs were associated with significantly increased risk of mortality over a seven year period, after adjusting for a range of potential confounders. As with all observational findings, however, these results are prone to bias arising from unmeasured and residual confounding.

Indexed as

MortalityAnti-Anxiety AgentsBenzodiazepinesFemaleHumansHypnotics and SedativesMaleMiddle AgedPrescription DrugsProportional Hazards ModelsRetrospective StudiesUnited KingdomAnti-Anxiety AgentsBenzodiazepinesHypnotics and SedativesPrescription Drugs

Identifiers

PMID24647164
PMCPMC3959619
OpenAlexW2044985256

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.