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Benzodiazepine drug use and adverse respiratory outcomes among older adults with COPD

Nicholas T. Vozoris, Hadas D. Fischer, Xuesong Wang, Anne L. Stephenson, Andrea S. Gershon, Andrea Gruneir, Peter C. Austin, Geoffrey M. Anderson, Chaim M. Bell, Sudeep S. Gill, Paula A. Rochon
European Respiratory Journal 2014; DOI: 10.1183/09031936.00008014
Nicholas T. Vozoris
1Division of Respirology, Dept of Medicine, St Michael's Hospital, Toronto, ON, Canada
2Dept of Medicine, University of Toronto, Toronto, ON, Canada
3Dept of Medicine, Queen's University, Kingston, ON, Canada
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Hadas D. Fischer
4Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
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Xuesong Wang
4Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
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Anne L. Stephenson
1Division of Respirology, Dept of Medicine, St Michael's Hospital, Toronto, ON, Canada
2Dept of Medicine, University of Toronto, Toronto, ON, Canada
5Dept of Medicine and Keenan Research Centre in the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
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Andrea S. Gershon
2Dept of Medicine, University of Toronto, Toronto, ON, Canada
4Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
6Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
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Andrea Gruneir
4Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
6Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
7Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
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Peter C. Austin
4Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
6Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
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Geoffrey M. Anderson
4Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
6Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
7Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
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Chaim M. Bell
2Dept of Medicine, University of Toronto, Toronto, ON, Canada
4Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
6Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
8Division of General Internal Medicine, Dept of Medicine, Mount Sinai Hospital, Toronto, ON, Canada
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Sudeep S. Gill
3Dept of Medicine, Queen's University, Kingston, ON, Canada
4Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
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Paula A. Rochon
2Dept of Medicine, University of Toronto, Toronto, ON, Canada
4Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
6Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
7Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
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Abstract

Our purpose was to evaluate the association of new benzodiazepine use relative to non-use with adverse clinical respiratory outcomes among older adults with chronic obstructive pulmonary disease (COPD).

This was a retrospective population-based cohort study of Ontario, Canada, residents between 2003 and 2010. A validated algorithm was applied to health administrative data to identify adults aged 66 years and older with COPD. Relative risks (RRs) of several clinically important respiratory outcomes were examined within 30 days of incident benzodiazepine use compared with non-use, applying propensity score matching.

New benzodiazepine users were at significantly higher risk for outpatient respiratory exacerbations (RR 1.45, 95% CI 1.36–1.54) and emergency room visits for COPD or pneumonia (RR 1.92, 95% CI 1.69–2.18) compared to non-users. Risk of hospitalisation for COPD or pneumonia was also increased in benzodiazepine users, but was nonsignificant (RR 1.09, 95% CI 1.00–1.20). There were no significant differences in intensive care unit admissions between the two groups and all-cause mortality was slightly lower among new versus non-users.

Benzodiazepines were associated with increased risk for several serious adverse respiratory outcomes among older adults with COPD. The findings suggest that decisions to use benzodiazepines in older patients with COPD need to consider potential adverse respiratory outcomes.

Abstract

Benzodiazepines are associated with increased risk of adverse respiratory outcomes among older adults with COPD http://ow.ly/uTScu

  • Received January 9, 2014.
  • Accepted February 28, 2014.
  • © ERS
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Benzodiazepine drug use and adverse respiratory outcomes among older adults with COPD
Nicholas T. Vozoris, Hadas D. Fischer, Xuesong Wang, Anne L. Stephenson, Andrea S. Gershon, Andrea Gruneir, Peter C. Austin, Geoffrey M. Anderson, Chaim M. Bell, Sudeep S. Gill, Paula A. Rochon
European Respiratory Journal Apr 2014, erj00080-2014; DOI: 10.1183/09031936.00008014

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Benzodiazepine drug use and adverse respiratory outcomes among older adults with COPD
Nicholas T. Vozoris, Hadas D. Fischer, Xuesong Wang, Anne L. Stephenson, Andrea S. Gershon, Andrea Gruneir, Peter C. Austin, Geoffrey M. Anderson, Chaim M. Bell, Sudeep S. Gill, Paula A. Rochon
European Respiratory Journal Apr 2014, erj00080-2014; DOI: 10.1183/09031936.00008014
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