Evidence map›Paper›PMID 39292394›Full record

ArticleDrugs & aging2024

Fall Outcomes in Older Adults Following Benzodiazepine/Z-Drug Discontinuation: A Retrospective Cohort Study in an Academic Health System.

Nicole J Schindler, Lindsay Zepel, Matthew L Maciejewski, Susan N Hastings, Amy Clark, Sascha Dublin, Ladia Albertson-Junkans, Juliessa M Pavon

Abstract read
In one paragraph

Article in Drugs & aging, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Article
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

8 authors.

Nicole J SchindlerDuke University School of Medicine, Durham, NC, USA. nicole.schindler@duke.edu.ORCID 0000-0002-6445-5376
Lindsay ZepelDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
Matthew L MaciejewskiDuke University School of Medicine, Durham, NC, USA.
Susan N HastingsDuke University School of Medicine, Durham, NC, USA.
Amy ClarkDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
Sascha DublinKaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
Ladia Albertson-JunkansKaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
Juliessa M PavonDuke University School of Medicine, Durham, NC, USA. Juliessa.pavon@duke.edu.

Funding

Resource Core 3 - Metabolomics CoreP30AG028716 · NIA · DUKE UNIVERSITY · PI CATHLEEN S COLON-EMERIC, Susan Nicole Hastings · 2006 to 2026
$24.6M
U.S. Deprescribing Research NetworkR24AG064025 · NIA · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · PI BOYD, CYNTHIA MELINDA, STEINMAN, MICHAEL A. · 2019 to 2023
$9.9M
Deprescribing Central Nervous System Medications in Hospitalized Older AdultsK23AG058788 · NIA · DUKE UNIVERSITY · PI PAVON, JULIESSA M · 2019 to 2023
$797k
National Institutes on Aging Northern California Institute for Research and Education grant R24AG064025National Institutes on Aging Northern California Institute for Research and Education subaward 5K23-AG058788National Institutes on Aging Northern California Institute for Research and Education subaward STE2196-13(USDeN)NIA NIH HHS K23 AG058788NIA NIH HHS P30 AG028716NIA NIH HHS R24 AG064025Veteran Affairs Health Services Research and Development Service RCS 10-39
6 · The paper itself

Abstract

backgroundBenzodiazepines and z-drugs increase the fall risk in older adults. There is a lack of real-world data examining the association between falls and deprescribing medications.

objectiveIn a retrospective cohort study of older adults with chronic benzodiazepine or z-drug use receiving care at an academic health system from January 2017 to December 2020, we explored the association between medication discontinuation and falls.

methodsChronic use was defined as ≥ 3 medication dispensings and cumulative days' supply ≥ 45 days within 100 days in 2018. Discontinuation was defined as a dispensing gap of ≥ 180 days within 1 year of chronic use eligibility, with a secondary definition requiring a gap of ≥ 90 days. Non-discontinuers (n = 524) were matched 4:1 to discontinuers (n = 131) if they had a fill in the same month as the matched discontinuation index date. The association between discontinuation and a fall during 2.25-year follow-up was assessed using Cox proportional hazards models. The analysis was repeated using a gap of ≥ 90 days (n = 279 discontinuers; 1116 matched non-discontinuers).

resultsThe cumulative incidence of falls-related acute visits was 6.9% for discontinuers and 9.7% for non-discontinuers [adjusted hazard ratio (HR) 0.65, 95% confidence interval (CI) 0.31-1.31]. Using the 90-day-gap definition, the cumulative incidence was 9.3% for discontinuers and 8.5% for non-discontinuers (HR 1.12, 95% CI 0.70-1.77).

conclusionBenzodiazepine/z-drug discontinuation was not associated with reduced risk of falls. However, the relationship between discontinuation and falls varies depending on the definitions used. It is essential to examine different discontinuation definitions in larger studies while considering other relevant clinical outcomes.

Indexed as

Accidental FallsBenzodiazepinesDeprescriptionsAgedAged, 80 and overCohort StudiesFemaleHumansMaleRetrospective StudiesBenzodiazepines

Identifiers

PMID39292394
PMCPMC12425156

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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.