非二胺催眠药和警察报告的老年人中机动车事故风险:一个连续的目标试验仿真试验
Andrew R Zullo1,2,3,4,5, Marzan A Khan2, Melissa R Pfeiffer6
1Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island 02912, United States.
American journal of epidemiology
|July 3, 2024
概括
非二胺催眠药 (Z药物) 可能不会显著增加老年人机动车撞车风险. 持续的Z-药物治疗显示,车祸的风险降低,这表明明智的处方,而不是完全避免.
科学领域:
- 药学流行病学 药学流行病学
- 老年医学 老年医学
- 交通安全 交通安全
背景情况:
- 非二胺催眠剂或Z药物通常用于老年人的失眠.
- 潜在的副作用包括昏昏欲睡和反应时间延迟,引发了对机动车辆碰撞 (MVC) 风险的担忧.
研究的目的:
- 估计启动Z药物治疗对老年人12周MVC风险的影响.
- 为老年人提供有关驾驶安全的Z药物处方实践信息.
主要方法:
- 使用链接的新泽西州驾驶执照,MVC数据和医疗保险索赔 (2007-2017) 进行序列目标试验模拟.
- 用聚合后勤回归模型对待和审查权重的逆概率.
- 分析包括257,554个人体试验 (103,371人接受Z药物治疗).
主要成果:
- 治疗意图分析显示,MVC风险的增加不显著 (RR,1.06;95%CL,0.95-1.16).
- 每项方案分析表明,在持续的Z药物治疗中,MVC风险降低 (RR,0.83;95%CL,0.74-0.92).
- 976个MVC发生在Z药物治疗者和1249个未接受治疗的人试验中.
结论:
- 对于老年患者,Z型药物应谨慎处方,平衡失眠治疗与潜在风险.
- 对于MVC风险的担忧不应导致该人群中完全拒绝使用Z药物.
- 持续使用可能与MVC风险低于最初推测的风险有关.
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