Evidence map›Paper›PMID 27241038›Full record

ArticleDrugs & aging2016

Changing Pattern of Sedative Use in Older Adults: A Population-Based Cohort Study.

Andrea Iaboni, Susan E Bronskill, Katelyn B Reynolds, Xuesong Wang, Paula A Rochon, Nathan Herrmann, Alastair J Flint

Abstract read
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In one paragraph

Article in Drugs & aging, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 1 pooled it
3.6field-weighted citation impact, top 8% 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

24 citing papers in PubMed, 1 synthesis or guideline pooled it, 51 citations in OpenAlex.

  1. Pooled it
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  15. Psychotropic drugs for the behavioural and psychological symptoms of dementia: no free ride.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2018
    Article
  16. Comparative risk of harm associated with trazodone or atypical antipsychotic use in older adults with dementia: a retrospective cohort study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2018
    Article
  17. Article
  18. Observational
  19. Sleep and Long-Term Care.Sleep medicine clinics · 2018
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 1 country.

Andrea IaboniCentre for Mental Health, University Health Network, Toronto, ON, Canada. Andrea.iaboni@uhn.ca.
Susan E BronskillInstitute for Clinical Evaluative Sciences, Toronto, ON, Canada.
Katelyn B ReynoldsDepartment of Psychiatry, University of Toronto, Toronto, ON, Canada.
Xuesong WangInstitute for Clinical Evaluative Sciences, Toronto, ON, Canada.
Paula A RochonInstitute for Clinical Evaluative Sciences, Toronto, ON, Canada.
Nathan HerrmannDepartment of Psychiatry, University of Toronto, Toronto, ON, Canada.
Alastair J FlintCentre for Mental Health, University Health Network, Toronto, ON, Canada.
Institute for Clinical Evaluative Sciences · CAUniversity Health Network · CAInstitute of Health Services and Policy Research · CASunnybrook Health Science Centre · CAUniversity of Toronto · CA

Funding

CIHR
6 · The paper itself

Abstract

backgroundBenzodiazepine medications have well-documented side effects, and their prescription rates in older adults have been declining. Trazodone and quetiapine are medications with sedative properties when used at low doses and are commonly used off-label for sleep or behavioral symptoms in older adults.

objectiveOur objective was to describe the shifting patterns of sedative prescription in older adults over time by comparing changes in benzodiazepine, trazodone, and quetiapine dispensing between community and long-term care settings.

methodsWe conducted a population-based serial cross-sectional study to compare the patterns of sedative dispensing (specifically, benzodiazepines, trazodone, and quetiapine) to individuals aged ≥66 years between 1 January 2002 and 31 March 2013 in Ontario, Canada. We compared rates of use between long-term care and community settings and used linear regression models to characterize the magnitude and direction of the rate of change in sedative use by age, sex, and dementia status.

resultsThe dispensing of trazodone and quetiapine increased over time, and this coincided with a decrease in benzodiazepine dispensing. This pattern was particularly apparent in the oldest cohort and in those with dementia. Benzodiazepines, trazodone, and quetiapine were associated with high rates of psychotropic polypharmacy. Overall trends were similar in long-term care and the community.

conclusionsWhile benzodiazepine prescribing is declining among older adults in Ontario over time, there is a corresponding shift towards low-dose, off-label prescribing of trazodone and quetiapine and psychotropic polypharmacy. These prescribing trends highlight sedative substitution and reinforce the need to confirm efficacy and safety of this practice.

Indexed as

AdultAgedBenzodiazepinesCohort StudiesCross-Sectional StudiesDementiaDrug UtilizationFemaleHumansHypnotics and SedativesLong-Term CareOff-Label UseOntarioPolypharmacyPractice Patterns, Physicians'Psychotropic DrugsBenzodiazepinesHypnotics and SedativesPsychotropic Drugs

Identifiers

PMID27241038
OpenAlexW2469722178

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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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.