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Method for Simultaneous fMRI/EEG Data Collection during a Focused Attention Suggestion for Differential Thermal Sensation
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Association between hypnotics use and increased mortality: causation or confounding?

C Ineke Neutel1, Helen L Johansen

  • 1School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, 451 Smyth Road (Room 3105) Roger-Guindon Building, Ottawa, K1H 8M5, Ontario, Canada, cneutel@uottawa.ca.

European Journal of Clinical Pharmacology
|April 8, 2015
PubMed
Summary
This summary is machine-generated.

Benzodiazepine and/or z-hypnotic (BZZ) use is associated with increased mortality. However, this study suggests increased BZZ prescriptions near death are likely due to symptom management in terminal illness, not causation.

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Area of Science:

  • Pharmacology
  • Gerontology
  • Epidemiology

Background:

  • Benzodiazepines and/or z-hypnotics (BZZ) are frequently prescribed medications.
  • Numerous studies report an association between BZZ use and increased mortality.
  • The causal relationship between BZZ use and mortality remains debated, with confounding factors proposed.

Purpose of the Study:

  • To investigate the potential confounding factor of symptom management in terminal illness contributing to the observed association between BZZ use and mortality.
  • To analyze BZZ prescription patterns in relation to proximity to death.

Main Methods:

  • A population-based case-control study using Norwegian registry data from 2010.
  • Included 8862 deaths and 898,289 controls aged 41-80.
  • Analyzed BZZ use in the two years preceding death or a matched index date for controls.

Main Results:

  • Individuals using BZZ had a 2.3-fold increased odds of death.
  • BZZ prescription rates increased significantly in the final two months before death (40-45%).
  • Younger age groups showed a higher odds ratio for BZZ use near death (5.8) compared to older groups (1.8), adjusted for age and sex.

Conclusions:

  • The observed association between BZZ use and mortality is likely confounded by the need for symptomatic treatment in terminal illness.
  • Similar patterns of increased use near death were noted for other medications like opioids.
  • The findings suggest that the association is not primarily causal but rather reflects disease progression and palliative care.