ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2026
Association between sedative prescriptions after hospital discharge and falls and other adverse events in older adults: a population-based cohort study.
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Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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12 authors.
Lisa D BurryDepartments of Pharmacy and Medicine (Burry), Sinai Health Research, Sinai Health; Leslie Dan Faculty of Pharmacy (Burry, Dolovich) and Interdepartmental Division of Critical Care (Burry, Scales, Fowler), University of Toronto, Toronto, Ont.; Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care (Rose), King's College London, London, UK; Department of Critical Care Medicine (Pinto, Scales, Fowler), Sunnybrook Health Sciences Centre, Toronto, Ont.; Faculté de Pharmacie, Université de Montréal; Pharmacy Department (Williamson), Hôpital du Sacré-Cœur de Montréal; Centre de recherche du CIUSSS du Nord-de-l'Île-de-Montréal (Williamson), Montréal, Que.; Evaluative Clinical Sciences Platform, Sunnybrook Research Institute (Hill), Sunnybrook Health Sciences Centre; ICES (Scales, Bronskill, Fowler); Sunnybrook Research Institute (Bronskill, Fowler); Institute of Health Policy, Management and Evaluation (Bronskill, Fowler), Dalla Lana School of Public Health, University of Toronto; ICES (Fu); Department of Medicine, Sinai Health (Bell); Departments of Medicine and Health Policy, Management and Evaluation (Bell), University of Toronto; Department of Anesthesiology (Wunsch), Weill Cornell Medicine; Sunnybrook Research Institute (Wunsch); Department of Anesthesiology and Pain Medicine (Wunsch), University of Toronto, Toronto, Ont. lisa.burry@sinaihealth.ca.
Louise RoseDepartments of Pharmacy and Medicine (Burry), Sinai Health Research, Sinai Health; Leslie Dan Faculty of Pharmacy (Burry, Dolovich) and Interdepartmental Division of Critical Care (Burry, Scales, Fowler), University of Toronto, Toronto, Ont.; Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care (Rose), King's College London, London, UK; Department of Critical Care Medicine (Pinto, Scales, Fowler), Sunnybrook Health Sciences Centre, Toronto, Ont.; Faculté de Pharmacie, Université de Montréal; Pharmacy Department (Williamson), Hôpital du Sacré-Cœur de Montréal; Centre de recherche du CIUSSS du Nord-de-l'Île-de-Montréal (Williamson), Montréal, Que.; Evaluative Clinical Sciences Platform, Sunnybrook Research Institute (Hill), Sunnybrook Health Sciences Centre; ICES (Scales, Bronskill, Fowler); Sunnybrook Research Institute (Bronskill, Fowler); Institute of Health Policy, Management and Evaluation (Bronskill, Fowler), Dalla Lana School of Public Health, University of Toronto; ICES (Fu); Department of Medicine, Sinai Health (Bell); Departments of Medicine and Health Policy, Management and Evaluation (Bell), University of Toronto; Department of Anesthesiology (Wunsch), Weill Cornell Medicine; Sunnybrook Research Institute (Wunsch); Department of Anesthesiology and Pain Medicine (Wunsch), University of Toronto, Toronto, Ont.
Ruxandra PintoDepartments of Pharmacy and Medicine (Burry), Sinai Health Research, Sinai Health; Leslie Dan Faculty of Pharmacy (Burry, Dolovich) and Interdepartmental Division of Critical Care (Burry, Scales, Fowler), University of Toronto, Toronto, Ont.; Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care (Rose), King's College London, London, UK; Department of Critical Care Medicine (Pinto, Scales, Fowler), Sunnybrook Health Sciences Centre, Toronto, Ont.; Faculté de Pharmacie, Université de Montréal; Pharmacy Department (Williamson), Hôpital du Sacré-Cœur de Montréal; Centre de recherche du CIUSSS du Nord-de-l'Île-de-Montréal (Williamson), Montréal, Que.; Evaluative Clinical Sciences Platform, Sunnybrook Research Institute (Hill), Sunnybrook Health Sciences Centre; ICES (Scales, Bronskill, Fowler); Sunnybrook Research Institute (Bronskill, Fowler); Institute of Health Policy, Management and Evaluation (Bronskill, Fowler), Dalla Lana School of Public Health, University of Toronto; ICES (Fu); Department of Medicine, Sinai Health (Bell); Departments of Medicine and Health Policy, Management and Evaluation (Bell), University of Toronto; Department of Anesthesiology (Wunsch), Weill Cornell Medicine; Sunnybrook Research Institute (Wunsch); Department of Anesthesiology and Pain Medicine (Wunsch), University of Toronto, Toronto, Ont.
David R WilliamsonDepartments of Pharmacy and Medicine (Burry), Sinai Health Research, Sinai Health; Leslie Dan Faculty of Pharmacy (Burry, Dolovich) and Interdepartmental Division of Critical Care (Burry, Scales, Fowler), University of Toronto, Toronto, Ont.; Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care (Rose), King's College London, London, UK; Department of Critical Care Medicine (Pinto, Scales, Fowler), Sunnybrook Health Sciences Centre, Toronto, Ont.; Faculté de Pharmacie, Université de Montréal; Pharmacy Department (Williamson), Hôpital du Sacré-Cœur de Montréal; Centre de recherche du CIUSSS du Nord-de-l'Île-de-Montréal (Williamson), Montréal, Que.; Evaluative Clinical Sciences Platform, Sunnybrook Research Institute (Hill), Sunnybrook Health Sciences Centre; ICES (Scales, Bronskill, Fowler); Sunnybrook Research Institute (Bronskill, Fowler); Institute of Health Policy, Management and Evaluation (Bronskill, Fowler), Dalla Lana School of Public Health, University of Toronto; ICES (Fu); Department of Medicine, Sinai Health (Bell); Departments of Medicine and Health Policy, Management and Evaluation (Bell), University of Toronto; Department of Anesthesiology (Wunsch), Weill Cornell Medicine; Sunnybrook Research Institute (Wunsch); Department of Anesthesiology and Pain Medicine (Wunsch), University of Toronto, Toronto, Ont.
Andrea HillDepartments of Pharmacy and Medicine (Burry), Sinai Health Research, Sinai Health; Leslie Dan Faculty of Pharmacy (Burry, Dolovich) and Interdepartmental Division of Critical Care (Burry, Scales, Fowler), University of Toronto, Toronto, Ont.; Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care (Rose), King's College London, London, UK; Department of Critical Care Medicine (Pinto, Scales, Fowler), Sunnybrook Health Sciences Centre, Toronto, Ont.; Faculté de Pharmacie, Université de Montréal; Pharmacy Department (Williamson), Hôpital du Sacré-Cœur de Montréal; Centre de recherche du CIUSSS du Nord-de-l'Île-de-Montréal (Williamson), Montréal, Que.; Evaluative Clinical Sciences Platform, Sunnybrook Research Institute (Hill), Sunnybrook Health Sciences Centre; ICES (Scales, Bronskill, Fowler); Sunnybrook Research Institute (Bronskill, Fowler); Institute of Health Policy, Management and Evaluation (Bronskill, Fowler), Dalla Lana School of Public Health, University of Toronto; ICES (Fu); Department of Medicine, Sinai Health (Bell); Departments of Medicine and Health Policy, Management and Evaluation (Bell), University of Toronto; Department of Anesthesiology (Wunsch), Weill Cornell Medicine; Sunnybrook Research Institute (Wunsch); Department of Anesthesiology and Pain Medicine (Wunsch), University of Toronto, Toronto, Ont.
Damon ScalesDepartments of Pharmacy and Medicine (Burry), Sinai Health Research, Sinai Health; Leslie Dan Faculty of Pharmacy (Burry, Dolovich) and Interdepartmental Division of Critical Care (Burry, Scales, Fowler), University of Toronto, Toronto, Ont.; Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care (Rose), King's College London, London, UK; Department of Critical Care Medicine (Pinto, Scales, Fowler), Sunnybrook Health Sciences Centre, Toronto, Ont.; Faculté de Pharmacie, Université de Montréal; Pharmacy Department (Williamson), Hôpital du Sacré-Cœur de Montréal; Centre de recherche du CIUSSS du Nord-de-l'Île-de-Montréal (Williamson), Montréal, Que.; Evaluative Clinical Sciences Platform, Sunnybrook Research Institute (Hill), Sunnybrook Health Sciences Centre; ICES (Scales, Bronskill, Fowler); Sunnybrook Research Institute (Bronskill, Fowler); Institute of Health Policy, Management and Evaluation (Bronskill, Fowler), Dalla Lana School of Public Health, University of Toronto; ICES (Fu); Department of Medicine, Sinai Health (Bell); Departments of Medicine and Health Policy, Management and Evaluation (Bell), University of Toronto; Department of Anesthesiology (Wunsch), Weill Cornell Medicine; Sunnybrook Research Institute (Wunsch); Department of Anesthesiology and Pain Medicine (Wunsch), University of Toronto, Toronto, Ont.
Susan E BronskillDepartments of Pharmacy and Medicine (Burry), Sinai Health Research, Sinai Health; Leslie Dan Faculty of Pharmacy (Burry, Dolovich) and Interdepartmental Division of Critical Care (Burry, Scales, Fowler), University of Toronto, Toronto, Ont.; Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care (Rose), King's College London, London, UK; Department of Critical Care Medicine (Pinto, Scales, Fowler), Sunnybrook Health Sciences Centre, Toronto, Ont.; Faculté de Pharmacie, Université de Montréal; Pharmacy Department (Williamson), Hôpital du Sacré-Cœur de Montréal; Centre de recherche du CIUSSS du Nord-de-l'Île-de-Montréal (Williamson), Montréal, Que.; Evaluative Clinical Sciences Platform, Sunnybrook Research Institute (Hill), Sunnybrook Health Sciences Centre; ICES (Scales, Bronskill, Fowler); Sunnybrook Research Institute (Bronskill, Fowler); Institute of Health Policy, Management and Evaluation (Bronskill, Fowler), Dalla Lana School of Public Health, University of Toronto; ICES (Fu); Department of Medicine, Sinai Health (Bell); Departments of Medicine and Health Policy, Management and Evaluation (Bell), University of Toronto; Department of Anesthesiology (Wunsch), Weill Cornell Medicine; Sunnybrook Research Institute (Wunsch); Department of Anesthesiology and Pain Medicine (Wunsch), University of Toronto, Toronto, Ont.
Robert FowlerDepartments of Pharmacy and Medicine (Burry), Sinai Health Research, Sinai Health; Leslie Dan Faculty of Pharmacy (Burry, Dolovich) and Interdepartmental Division of Critical Care (Burry, Scales, Fowler), University of Toronto, Toronto, Ont.; Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care (Rose), King's College London, London, UK; Department of Critical Care Medicine (Pinto, Scales, Fowler), Sunnybrook Health Sciences Centre, Toronto, Ont.; Faculté de Pharmacie, Université de Montréal; Pharmacy Department (Williamson), Hôpital du Sacré-Cœur de Montréal; Centre de recherche du CIUSSS du Nord-de-l'Île-de-Montréal (Williamson), Montréal, Que.; Evaluative Clinical Sciences Platform, Sunnybrook Research Institute (Hill), Sunnybrook Health Sciences Centre; ICES (Scales, Bronskill, Fowler); Sunnybrook Research Institute (Bronskill, Fowler); Institute of Health Policy, Management and Evaluation (Bronskill, Fowler), Dalla Lana School of Public Health, University of Toronto; ICES (Fu); Department of Medicine, Sinai Health (Bell); Departments of Medicine and Health Policy, Management and Evaluation (Bell), University of Toronto; Department of Anesthesiology (Wunsch), Weill Cornell Medicine; Sunnybrook Research Institute (Wunsch); Department of Anesthesiology and Pain Medicine (Wunsch), University of Toronto, Toronto, Ont.
Lisa DolovichDepartments of Pharmacy and Medicine (Burry), Sinai Health Research, Sinai Health; Leslie Dan Faculty of Pharmacy (Burry, Dolovich) and Interdepartmental Division of Critical Care (Burry, Scales, Fowler), University of Toronto, Toronto, Ont.; Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care (Rose), King's College London, London, UK; Department of Critical Care Medicine (Pinto, Scales, Fowler), Sunnybrook Health Sciences Centre, Toronto, Ont.; Faculté de Pharmacie, Université de Montréal; Pharmacy Department (Williamson), Hôpital du Sacré-Cœur de Montréal; Centre de recherche du CIUSSS du Nord-de-l'Île-de-Montréal (Williamson), Montréal, Que.; Evaluative Clinical Sciences Platform, Sunnybrook Research Institute (Hill), Sunnybrook Health Sciences Centre; ICES (Scales, Bronskill, Fowler); Sunnybrook Research Institute (Bronskill, Fowler); Institute of Health Policy, Management and Evaluation (Bronskill, Fowler), Dalla Lana School of Public Health, University of Toronto; ICES (Fu); Department of Medicine, Sinai Health (Bell); Departments of Medicine and Health Policy, Management and Evaluation (Bell), University of Toronto; Department of Anesthesiology (Wunsch), Weill Cornell Medicine; Sunnybrook Research Institute (Wunsch); Department of Anesthesiology and Pain Medicine (Wunsch), University of Toronto, Toronto, Ont.
Longdi FuDepartments of Pharmacy and Medicine (Burry), Sinai Health Research, Sinai Health; Leslie Dan Faculty of Pharmacy (Burry, Dolovich) and Interdepartmental Division of Critical Care (Burry, Scales, Fowler), University of Toronto, Toronto, Ont.; Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care (Rose), King's College London, London, UK; Department of Critical Care Medicine (Pinto, Scales, Fowler), Sunnybrook Health Sciences Centre, Toronto, Ont.; Faculté de Pharmacie, Université de Montréal; Pharmacy Department (Williamson), Hôpital du Sacré-Cœur de Montréal; Centre de recherche du CIUSSS du Nord-de-l'Île-de-Montréal (Williamson), Montréal, Que.; Evaluative Clinical Sciences Platform, Sunnybrook Research Institute (Hill), Sunnybrook Health Sciences Centre; ICES (Scales, Bronskill, Fowler); Sunnybrook Research Institute (Bronskill, Fowler); Institute of Health Policy, Management and Evaluation (Bronskill, Fowler), Dalla Lana School of Public Health, University of Toronto; ICES (Fu); Department of Medicine, Sinai Health (Bell); Departments of Medicine and Health Policy, Management and Evaluation (Bell), University of Toronto; Department of Anesthesiology (Wunsch), Weill Cornell Medicine; Sunnybrook Research Institute (Wunsch); Department of Anesthesiology and Pain Medicine (Wunsch), University of Toronto, Toronto, Ont.
Chaim M BellDepartments of Pharmacy and Medicine (Burry), Sinai Health Research, Sinai Health; Leslie Dan Faculty of Pharmacy (Burry, Dolovich) and Interdepartmental Division of Critical Care (Burry, Scales, Fowler), University of Toronto, Toronto, Ont.; Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care (Rose), King's College London, London, UK; Department of Critical Care Medicine (Pinto, Scales, Fowler), Sunnybrook Health Sciences Centre, Toronto, Ont.; Faculté de Pharmacie, Université de Montréal; Pharmacy Department (Williamson), Hôpital du Sacré-Cœur de Montréal; Centre de recherche du CIUSSS du Nord-de-l'Île-de-Montréal (Williamson), Montréal, Que.; Evaluative Clinical Sciences Platform, Sunnybrook Research Institute (Hill), Sunnybrook Health Sciences Centre; ICES (Scales, Bronskill, Fowler); Sunnybrook Research Institute (Bronskill, Fowler); Institute of Health Policy, Management and Evaluation (Bronskill, Fowler), Dalla Lana School of Public Health, University of Toronto; ICES (Fu); Department of Medicine, Sinai Health (Bell); Departments of Medicine and Health Policy, Management and Evaluation (Bell), University of Toronto; Department of Anesthesiology (Wunsch), Weill Cornell Medicine; Sunnybrook Research Institute (Wunsch); Department of Anesthesiology and Pain Medicine (Wunsch), University of Toronto, Toronto, Ont.
Hannah WunschDepartments of Pharmacy and Medicine (Burry), Sinai Health Research, Sinai Health; Leslie Dan Faculty of Pharmacy (Burry, Dolovich) and Interdepartmental Division of Critical Care (Burry, Scales, Fowler), University of Toronto, Toronto, Ont.; Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care (Rose), King's College London, London, UK; Department of Critical Care Medicine (Pinto, Scales, Fowler), Sunnybrook Health Sciences Centre, Toronto, Ont.; Faculté de Pharmacie, Université de Montréal; Pharmacy Department (Williamson), Hôpital du Sacré-Cœur de Montréal; Centre de recherche du CIUSSS du Nord-de-l'Île-de-Montréal (Williamson), Montréal, Que.; Evaluative Clinical Sciences Platform, Sunnybrook Research Institute (Hill), Sunnybrook Health Sciences Centre; ICES (Scales, Bronskill, Fowler); Sunnybrook Research Institute (Bronskill, Fowler); Institute of Health Policy, Management and Evaluation (Bronskill, Fowler), Dalla Lana School of Public Health, University of Toronto; ICES (Fu); Department of Medicine, Sinai Health (Bell); Departments of Medicine and Health Policy, Management and Evaluation (Bell), University of Toronto; Department of Anesthesiology (Wunsch), Weill Cornell Medicine; Sunnybrook Research Institute (Wunsch); Department of Anesthesiology and Pain Medicine (Wunsch), University of Toronto, Toronto, Ont.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhether sedative prescriptions after hospital admissions are associated with poor patient outcomes is unknown. We sought to determine the incidence and risk of adverse events associated with sedatives in older adults within 30 days after hospital discharge.
methodsWe conducted a population-based cohort study involving older adults (age ≥ 66 yr) discharged alive from hospital in Ontario (2003 to 2023). We assessed the association of sedative prescriptions (benzodiazepines, antidepressant sedatives, or antipsychotics) filled within 7 days after discharge with falls (with or without fracture), emergency department (ED) visits, and hospital readmission. We used cause-specific proportional hazard regression for outcomes other than death and Cox proportional hazard models for death to assess the association between a sedative prescription filled after discharge and the outcomes. Because of an interaction with prehospital sedative prescription, we stratified results for prehospital sedative-naive and sedative-exposed status.
resultsAmong 1 868 484 older adults (mean age 77 yr, 52.1% female), 13.2% filled a sedative prescription after discharge; of these patients, 31.0% were sedative naive before hospital admission. Falls occurred in 1.6% (
interpretationNew sedative prescriptions filled within 7 days after discharge were associated with increased hazards of a fall, ED visit, hospital admission, and death within 30 days after discharge, with differences based on the sedative class. These findings have important implications for in-hospital medication review and falls-risk assessment for older adults in Canada.
Indexed as
Accidental FallsHypnotics and SedativesPatient DischargeAgedAged, 80 and overBenzodiazepinesCohort StudiesEmergency Room VisitsEmergency Service, HospitalFemaleHumansIncidenceMaleOntarioPatient ReadmissionProportional Hazards ModelsBenzodiazepinesHypnotics and Sedatives
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