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Published Online: 1 August 2011

Five-Year Trajectories of Long-Term Benzodiazepine Use by Adolescents: Patient, Provider, and Medication Factors

Abstract

Objectives:

This study sought to understand the stability of and change in benzodiazepine use among incident long-term benzodiazepine users over a five-year period and to investigate predictors of variation in use patterns from adolescence into adulthood.

Methods:

Long-term use was defined as receipt of benzodiazepine prescriptions for 31 or more cumulative days in a calendar year. Data for 1999–2005 were obtained from the National Health Insurance Research Database in Taiwan. Two age groups of incident long-term users in 2000 were identified—1,758 aged 12–15 and 5,265 aged 16–19—and their benzodiazepine prescription records from 2001 to 2005 were retrieved. Group-based trajectory analyses and polytomous logistic regression were performed to evaluate differential risk of benzodiazepine use over time.

Results:

From 3% to 5% of the incident benzodiazepine users were long-term users. Four distinct groups of users emerged from the five years of study data: occasional, decelerating, accelerating, and chronic users. Overall, one-quarter were accelerating or chronic users. A history of psychosis or epilepsy, prescription by providers from multiple specialties, and receipt of benzodiazepines with a long half-life or mixed indications significantly increased one's risk of becoming a chronic or accelerating user (range of adjusted odds ratios from 2 to 6).

Conclusions:

Patient characteristics and attributes of service providers and pharmacological agents played significant roles in benzodiazepine use patterns. Prescribers can reduce the risk of long-term use by assessing whether pediatric patients have received benzodiazepines from multiple doctors for various medical conditions. (Psychiatric Services 62:900–907, 2011)

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Figure 1 Five-year trajectory patterns of benzodiazepine prescription among incident long-term benzodiazepine users among adolescents in Taiwan
Table 1 Characteristics of incident benzodiazepine users in two age groups in Taiwan in 2000, by short- or long-term use
Table 2 Analysis of predictors of five-year benzodiazepine use patterns among adolescents in Taiwan, by age and trajectory group

Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Cover: The South Gorge, Appeldore, Isles of Shoals, by Childe Hassam. Oil on canvas, 22¼ × 18 inches. Collection of the Newark Museum, Newark, New Jersey. Photo credit: the Newark Museum/Art Resource, New York.
Psychiatric Services
Pages: 900 - 907
PubMed: 21807829

History

Published online: 1 August 2011
Published in print: August 2011

Authors

Details

Hsueh-Han Yeh, M.S.
Ms. Yeh, Dr. Chen, and Dr. Lin are affiliated with the Division of Mental Health and Addiction Medicine and Dr. Chang is with the Division of Biostatistics and Bioinformatics, all at the National Health Research Institutes, Miaoli, Taiwan.
Chuan-Yu Chen, Ph.D.
Ms. Yeh, Dr. Chen, and Dr. Lin are affiliated with the Division of Mental Health and Addiction Medicine and Dr. Chang is with the Division of Biostatistics and Bioinformatics, all at the National Health Research Institutes, Miaoli, Taiwan.
Ms. Fang is with the Institute of Public Health, National Yang-Ming University, Taipei, Taiwan, where Dr. Chen is also affiliated.
Shao-You Fang, M.S.
Ms. Fang is with the Institute of Public Health, National Yang-Ming University, Taipei, Taiwan, where Dr. Chen is also affiliated.
I-Shou Chang, Ph.D.
Ms. Yeh, Dr. Chen, and Dr. Lin are affiliated with the Division of Mental Health and Addiction Medicine and Dr. Chang is with the Division of Biostatistics and Bioinformatics, all at the National Health Research Institutes, Miaoli, Taiwan.
Erin Chia-Hsuan Wu, M.D., M.S.
Dr. Wu is with the Graduate Institute of Humanity in Medicine, Taipei Medical University, Taipei, Taiwan.
Keh-Ming Lin, M.D., M.P.H.
Ms. Yeh, Dr. Chen, and Dr. Lin are affiliated with the Division of Mental Health and Addiction Medicine and Dr. Chang is with the Division of Biostatistics and Bioinformatics, all at the National Health Research Institutes, Miaoli, Taiwan.

Notes

Send correspondence to Dr. Chen, Institute of Public Health, National Yang-Ming University, 155 Linong St., Section 2, Medical Building II, Room 204, Taipei, 112 Taiwan (e-mail: [email protected]).

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