Safety profile of hypnotics or sedatives on community-dwelling older adults aged 75 or older in Japan : A retrospective propensity-matched cohort study
© 2024 John Wiley & Sons Ltd..
OBJECTIVE: The purpose of the study is to assess if daily use of hypnotics increases mortality, aspiration pneumonia and hip fracture among relatively healthy individuals aged 75 years or older who lead independent lives in the community.
METHOD AND PATIENTS: Of the adults aged 75 years or older residing in Hokkaido prefecture of Japan (n = 705,538), those who did not meet several exclusion criteria were eligible for generating propensity score-matched cohorts (n = 214,723). Exclusion criteria included co-prescribed medications acting on the central nervous system, diagnoses of malignant neoplasm, dementia, depression, etc. We compared 33,095 participants who were prescribed hypnotics for daily use (hypnotic group) with a propensity score-matched cohort without a prescription (control group). Participants were followed for more than 42 months.
RESULTS: During the 42-month follow-up period, the incidence of the three outcome measures in the hypnotics group was significantly higher than that in the control group (aspiration pneumonia p < 0.001, hip fracture p = 0.007, and all-cause mortality p < 0.001). Sensitivity analyses utilizing inverse probability weighting demonstrated hazard ratios of 1.083 [1.023-1.146] for mortality, 1.117 [1.014-1.230] for aspiration pneumonia, and 1.720 [1.559-1.897] for hip fracture. Meanwhile, the attribute risk differences were 2.7, 1.5, and 1.0 per 1000 patient-years, respectively.
CONCLUSIONS: Although daily use of hypnotics increased the risk of three events, their attribute risk differences were fewer than 3.0 per 1000 patient-years. The results will help provide guidance on whether it is reasonable to prescribe hypnotics to geriatric population aged 75 or older leading independent lives in the community.
CLINICAL TRIAL REGISTRATION: UMIN-CTR UMIN000048398.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:39 |
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| Enthalten in: |
International journal of geriatric psychiatry - 39(2024), 4 vom: 15. Apr., Seite e6085 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Handa, Nobuhiro [VerfasserIn] |
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| Links: |
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| Themen: |
Aspiration pneumonia |
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| Anmerkungen: |
Date Completed 17.04.2024 Date Revised 17.04.2024 published: Print Citation Status MEDLINE |
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| doi: |
10.1002/gps.6085 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM371118743 |
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| 100 | 1 | |a Handa, Nobuhiro |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Safety profile of hypnotics or sedatives on community-dwelling older adults aged 75 or older in Japan |b A retrospective propensity-matched cohort study |
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| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024 John Wiley & Sons Ltd. | ||
| 520 | |a OBJECTIVE: The purpose of the study is to assess if daily use of hypnotics increases mortality, aspiration pneumonia and hip fracture among relatively healthy individuals aged 75 years or older who lead independent lives in the community | ||
| 520 | |a METHOD AND PATIENTS: Of the adults aged 75 years or older residing in Hokkaido prefecture of Japan (n = 705,538), those who did not meet several exclusion criteria were eligible for generating propensity score-matched cohorts (n = 214,723). Exclusion criteria included co-prescribed medications acting on the central nervous system, diagnoses of malignant neoplasm, dementia, depression, etc. We compared 33,095 participants who were prescribed hypnotics for daily use (hypnotic group) with a propensity score-matched cohort without a prescription (control group). Participants were followed for more than 42 months | ||
| 520 | |a RESULTS: During the 42-month follow-up period, the incidence of the three outcome measures in the hypnotics group was significantly higher than that in the control group (aspiration pneumonia p < 0.001, hip fracture p = 0.007, and all-cause mortality p < 0.001). Sensitivity analyses utilizing inverse probability weighting demonstrated hazard ratios of 1.083 [1.023-1.146] for mortality, 1.117 [1.014-1.230] for aspiration pneumonia, and 1.720 [1.559-1.897] for hip fracture. Meanwhile, the attribute risk differences were 2.7, 1.5, and 1.0 per 1000 patient-years, respectively | ||
| 520 | |a CONCLUSIONS: Although daily use of hypnotics increased the risk of three events, their attribute risk differences were fewer than 3.0 per 1000 patient-years. The results will help provide guidance on whether it is reasonable to prescribe hypnotics to geriatric population aged 75 or older leading independent lives in the community | ||
| 520 | |a CLINICAL TRIAL REGISTRATION: UMIN-CTR UMIN000048398 | ||
| 650 | 4 | |a Journal Article | |
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| 700 | 1 | |a Ono, Koki |e verfasserin |4 aut | |
| 700 | 1 | |a Akishita, Masahiro |e verfasserin |4 aut | |
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