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Table 2 Factors influencing regular use of BZDs/Z-drugs, regular use of BZDs only, and regular use of Z-drugs only in the studied sample – results from the multiple logistic regression models

From: The prevalence and prescribing patterns of benzodiazepines and Z-drugs in older nursing home residents in different European countries and Israel: retrospective results from the EU SHELTER study

Factors influencing regular use of drug groups

BZDs/Z-drugs

 

BZDs only

 

Z-drugs only

 

Adjusted

OR (95% CI) g

p value

 

Adjusted

OR (95% CI) g

p value

 

Adjusted

OR (95% CI) g

p value

Age

0.993

(0.985–1.002)

0.139

 

0.990

(0.980–0.999)

0.029

 

1.001

(0.986–1.017)

0.858

Gender

 Male – reference

1.000

  

1.000

  

1.000

 

 Female

1.063

(0.885–1.277)

0.513

 

1.061

(0.870–1.295)

0.558

 

1.073

(0.783–1.471)

0.661

Countries ordered by increasing prevalence of regular use of BZDs/Z-drugs

Countries ordered by increasing prevalence of regular use of BZDs only

Countries ordered by increasing prevalence of regular use of Z-drug only

Germany – ref.

1.000

 

England – ref.

1.000

 

Italy – ref.

1.000

 

England

1.532

(1.070–2.193)

0.020

Germany

0.971

(0.560–1.503)

0.731

Finland

1.311

(0.487–3.527)

0.592

The Czech Republic

1.509

(1.064–2.140)

0.021

The Czech Republic

1.857

(1.192–2.894)

0.006

The Netherlands

1.093

(0.415–2.880)

0.857

Finland

1.888

(1.324–2.691)

< 0.001

Finland

3.298

(2.146–5.068)

< 0.001

The Czech Republic

3.662

(1.570–8.542)

0.003

Italy

2.631

(1.857–3.727)

< 0.001

France

3.655

(2.226–6.002)

< 0.001

Germany

3.809

(1.655–8.769)

0.002

The Netherlands

2.424

(1.738–3.381)

< 0.001

Italy

4.368

(2.864–6.622)

< 0.001

Israel

5.620

(2.478–12.744)

< 0.001

France

5.250

(3.473–7.936)

< 0.001

The Netherlands

4.008

(2.700–6.164)

< 0.001

England

7.727

(3.428–17.420)

< 0.001

Israel

6.660

(4.823–9.198)

< 0.001

Israel

9.715

(6.501–14.517)

< 0.001

France

20.953

(8.970–48.940)

< 0.001

CPSa

0.974

(0.908–1.044)

0.459

 

0.953

(0.883–1.030)

0.224

 

0.998

(0.892–1.115)

0.965

ADLHb

0.992

(0.981–1.003)

0.151

 

0.991

(0.979–1.005)

0.131

 

0.993

(0.976–1.012)

0.479

Pain scalec

1.113

(1.004–1.234)

0.041

 

1.119

(1.000–1.252)

0.050

 

1.095

(0.926–1.294)

0.290

CAP Deliriumd

0.992

(0.897–1.097)

0.876

 

1.012

(0.910–1.125)

0.830

 

0.884

(0.715–1.092)

0.253

Depression scalee

1.052

(1.020–1.085)

0.001

 

1.064

(1.030–1.100)

< 0.001

 

1.012

(0.960–1.067)

0.659

Communication scalef

0.941

(0.898–0.986)

0.010

 

0.955

(0.907–1.005)

0.077

 

0.930

(0.861–1.006)

0.069

Anxietyh

 Not present – reference

1.000

  

1.000

  

1.000

 

 Diagnosis present

1.171

(0.608–2.252)

0.637

 

1.274

(0.639–2.540)

0.491

 

1.162

(0.407–3.323)

0.779

 Diagnosis present, treated

1.887

(1.382–2.578)

< 0.001

 

2.320

(1.688–3.187)

< 0.001

 

0.584

(0.316–1.078)

0.085

 Diagnosis present, monitored

0.820

(0.525–1.280)

0.382

 

0.792

(0.492–1.275)

0.337

 

0.957

(0.423–2.167)

0.917

Difficulty falling asleep

 Not present – reference

1.000

  

1.000

  

1.000

 

 Diagnosis present in medical record, problem not exhibited

2.687

(2.098–3.443)

< 0.001

 

2.392

(1.837–3.115)

< 0.001

 

2.767

(1.859–4.119)

< 0.001

 Exhibited 1 of 3 days

1.953

(1.315–2.901)

< 0.001

 

1.501

(0.977–2.306)

0.063

 

3.052

(1.647–5.654)

< 0.001

 Exhibited 2 of 3 days

1.777

(1.118–2.824)

0.015

 

1.659

(1.007–2.731)

0.047

 

1.395

(0.578–3.370)

0.459

 Exhibited daily of 3 days

3.274

(2.481–4.320)

< 0.001

 

2.426

(1.797–3.275)

< 0.001

 

3.526

(2.373–5.238)

< 0.001

  1. Results in bold indicate statistically significant results
  2. a CPS– Cognitive Performance Scale [26] was used to access cognitive status. It includes five items: cognitive skills for daily decision making, short-term memory problems, procedural memory problems, making self-understood, and eating ability. Scores of CPS items range from 0 (intact) to 6 (very severe cognitive impairment), and any score ≥ 2 indicates clinically significant cognitive impairment (from mild to very severe stages)
  3. b ADLH scale –Activities of Daily Living Hierarchy scale [25] comprises 7 items: personal hygiene, dressing upper body, dressing lower body, locomotion, toilet use, bed mobility, eating. Each item is scored from 1 = requires supervision to 4 = total dependence. The scale ranges from 0 to 28, with higher scores reflecting greater level of dependency and difficulties in performing activities
  4. c Pain scale [28] - summarizes the reported presence and intensity of pain. It comprises two items: pain symptoms-frequency and pain symptoms-intensity of highest level of pain present. The scores range from 0 = no pain to 4 = daily excruciating pain
  5. d CAP Delirium [30] - this scale comprises 4 items: easily distracted, disorganized speech, mental function varies over day, change in decision making. The scale ranges from 0 to 4, with higher values indication increase likelihood of delirium
  6. e Depression scale [27] - is based on the self-reported mood items and indicates the presence of depressed mood and anxiety. It consists of 3 self-reported mood items, while each question can be scored from 0 to 2 with the maximum overall score of 6. The score of this scale range from 0 = no symptoms of depression to 6 = all symptoms present in last 3 days/24 h: high likelihood of depression
  7. f Communication scale [29] – consists of two items: making self-understood (expression) and ability to understand others (comprehension), while not taking directly into consideration hearing and visual impairment. It is primarily focused on dysphasia and similar syndromes. The scores range from 0 = intact to 8 = very severe impairment
  8. g Adjusted for all factors in univariate logistic regression: age, gender, functional and cognitive status, anxiety, insomnia, depression, delirium, pain, and communication problems
  9. h “Diagnosis present” – recorded when diagnosis confirmed as diagnosed clinical condition in medical charts; “Diagnosis present, treated” – resident’s diagnosis is being treated by active treatment (incl. Drug therapy, therapeutic rehabilitation services, other medical or skilled nursing interventions); “Diagnosis present, monitored” – resident’s diagnosis is being only monitored (e.g., by laboratory tests, vital signs, etc.) but no active treatment is provided
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BMC Geriatrics

ISSN: 1471-2318

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