Abstract
Objective
The health-related quality of life (HRQOL) of initial benzodiazepine users was measured over time. Furthermore, benzodiazepineusage characteristics as determinants of change in mental and physical health status of the benzodiazepine users were examined.
Methods
In the only pharmacy of a Dutch community of 13500 and during four months from November 1994, all patients with a benzodiazepine prescription and no history of benzodiazepine use over a period of 12 months before inclusion, were invited to participate. A total of 106 initial benzodiazepine users were matched for age and gender. In a six-month follow-up study, HRQOL was measured with the RAND-36. Consequently, in a nested case control design, determinants of change in mental and physical functioning over the six-month period were analysed using the Mental Component Summary and the Physical Component Summary.
Results
At baseline, initial benzodiazepine users showed a lower HRQOL as compared to reference subjects. After six-month follow-up, enzodiazepine users presented an absolute increase in HRQOL, while the reference subjects maintained a stable HRQOL. Diazepam and the male gender were associated with an increase in physical functioning over time. Younger age, a lower daily dose (DDD < 0.75) and a period of use between 16 and 60 days were associated with better mental functioning over time.
Conclusion
This study is one of the first to associate improvement in HRQOL over time of starting benzodiazepine users with specific usage characteristics, such as limited duration of use and a low dosage.
Similar content being viewed by others
References
LE. Hollister (1983) ArticleTitleThe pre-benzodiazepine era Psychoactive Drugs 15 1–2
L Hollister F Molzenbecker R. Degan (1961) ArticleTitleWithdrawal reactions from chlordiazepoxide (Librium) Psychopharmacologia 2 63–8 Occurrence Handle10.1007/BF00429621 Occurrence Handle1:STN:280:CC%2BD3svptlc%3D Occurrence Handle13715373
H Petursson MH. Lader (1981) ArticleTitleBenzodiazepine dependence Br J Addict 76 133–45 Occurrence Handle1:STN:280:Bi2D3c%2Fis1U%3D Occurrence Handle7023521
MH. Lader (1983) ArticleTitleDependence on benzodiazepines J Clin Psychiatry 44 121–7 Occurrence Handle1:STN:280:BiyC28%2FosVY%3D
RT Owen P. Tyrer (1983) ArticleTitleBenzodiazepine dependence: a review of evidence Drugs 25 385–98 Occurrence Handle1:STN:280:BiyB3cbivVc%3D Occurrence Handle6133736
GD Mellinger MB Balter EH. Uhlenhuth (1984) ArticleTitleAnti-anxiety agents: duration of use and characteristics of users in the U.S.A Curr Med Res Opin 8 4
M Olfson HA. Pincus (1994) ArticleTitleUse of benzodiazepines in the community Arch Intern Med 154 1235–40 Occurrence Handle10.1001/archinte.154.11.1235 Occurrence Handle1:STN:280:ByuB28zjtFY%3D Occurrence Handle7911297
GC Dunbar MH Perera FA. Jenner (1989) ArticleTitlePatterns of benzodiazepine use in Great Britain as measured by a General Population Survey Br J Psychiatry 155 836–41 Occurrence Handle1:STN:280:By%2BC2cbkvFE%3D Occurrence Handle2575921
P Tyrer R. Owen (1984) ArticleTitleAnxiety in primary care: is short term drug treatment appropriate? J Psychiatr Res 18 73–8 Occurrence Handle10.1016/0022-3956(84)90048-7 Occurrence Handle1:STN:280:BiuC1cfitVY%3D Occurrence Handle6371225
MH Lader H. Petursson (1983) ArticleTitleRational use of anxiolytic/sedative drugs Drugs 25 514–28 Occurrence Handle1:CAS:528:DyaL3sXktFGqtr4%3D Occurrence Handle6134609
InstitutionalAuthorNameCommittee on the review of medicines (1980) ArticleTitleSystematic review of the benzodiazepines BMJ 141 917–21
DJ Greenblatt RI. Shader (1974) Benzodiazepines in clinical practice Raven Press New York
K Rickles RW. Downing (1976) ArticleTitleDrug and placebo treated neurotic outpatients Arch Gen Psychiatry 16 369–72
H Dasberg HM. Praag ParticleVan (1974) ArticleTitleThe therapeutic effect of short term oral diazepam treatment on acute clinical anxiety in a crisis centre Acta Psychiatr Scand 50 326–40 Occurrence Handle1:STN:280:CSqD3szntFc%3D Occurrence Handle4609190
AK Shapiro EL Sruening E Shapiro BI. Milcarek (1984) ArticleTitleDiazepam: how much better than placebo? J Psychiatric Res 18 51–73
J Catalan D. Gath (1985) ArticleTitleBenzodiazepines in general practice: time for a decision BMJ 290 1374–6 Occurrence Handle1:STN:280:BiqB3c%2Fms1A%3D Occurrence Handle3922500
J Catalan DH Gath A Bond G Edmonds P Martin J. Ennis (1988) ArticleTitleGeneral practice patients on long term psychotropic drugs Br J Psychiatry 152 399 Occurrence Handle1:STN:280:BiaD3c7ntFc%3D Occurrence Handle3139126
GD Mellinger MB Balter EH. Uhlenhuth (1984) ArticleTitlePrevalence and correlates of the long-term use of anxiolytics JAMA 251 375–9 Occurrence Handle10.1001/jama.251.3.375 Occurrence Handle1:STN:280:BiuD1M%2FlsVw%3D Occurrence Handle6140318
RJ Simpson KG Power LA Wallace MH Butcher V Swanson EC. Simpson (1990) ArticleTitleControlled comparison of the characteristics of long-term benzodiazepine users in general practice Br J Gen Pract 40 22–6 Occurrence Handle1:STN:280:By%2BC1MfmvVI%3D Occurrence Handle1969288
EK Rodrigo MB King P. Williams (1988) ArticleTitleHealth of long term benzodiazepine users BMJ 296 603–6 Occurrence Handle1:STN:280:BieC28vjvVM%3D Occurrence Handle2894884
A Mant RP Mattick S Burgh ParticleDe N Donnelly W. Hall (1995) ArticleTitleBenzodiazepine prescribing in general practice: dispelling some myths Fam Pract 12 37–43 Occurrence Handle1:STN:280:ByqA1MvjtFE%3D Occurrence Handle7665039
M Romach U Busto G Somer HL Kaplan E. Sellers (1995) ArticleTitleClinical aspects of chronic use of alprazolam and lorazepam Am J Psychiatry 152 1161–7 Occurrence Handle1:STN:280:ByqA2M7jvFY%3D Occurrence Handle7625464
R. Hulten ParticleVan (2000) ArticleTitleCharacteristics of current benzodiazepine users as indicators of differences in physical and mental health Pharm World Sci 22 96–101 Occurrence Handle10.1023/A:1008749220107 Occurrence Handle11028263
S. Marino (1993) ArticleTitleIll-health and social predictors of psychotropic drug prescription in general practice Int J Soc Psychiatry 39 167–76 Occurrence Handle1:STN:280:ByuD2c7ovVU%3D Occurrence Handle8225813
L Douglas Ried RE Johnson DA. Gettman (1998) ArticleTitleBenzodiazepine exposure and functional status in older people J Am Geriatr Soc 46 71–6 Occurrence Handle9434668
H. Ashton (1994) ArticleTitleGuidelines for the rational use of benzodiazepines. What and what to use Drugs 48 24–40
KI Zee ParticleVan der R. Sanderman (1993) Het meten van de algemene gezondheidstoestand met de RAND-36. Een handleiding. [Measuring general health status with the RAND-36. Users manual.] Groningen Northern Center of Health Care Research The Netherlands
JE Ware CD. Sherbourne (1992) ArticleTitleThe MOS 36-Item Short-Form Health Survey (SF-36), I: Conceptual framework and item selection Med Care 30 473–83 Occurrence Handle1593914
RD Hays CD Sherbourne RM. Mazel (1993) ArticleTitleThe RAND 36-Item Health Survey 1.0 Health Econ 2 217–27 Occurrence Handle1:STN:280:ByuC3c7gs1M%3D Occurrence Handle8275167
JE Ware M Koskinski SD. Keller (1994) SF-36 physical and mental summary scales: a user’s manual The Health Institute Boston, Massachusetts
JE Ware M Kosinski MS Bayliss CA McHorney WH Rogers A. Raczek (1995) ArticleTitleComparison of Methods for the Scoring and Statistical Analysis of SF-36 health profile and summary measures: Summary of results from the medical putcome study Med Care 33 AS264–79 Occurrence Handle7723455
L Morrin S Black R. Reid (2000) ArticleTitleImpact of duration in a cardiac rehabilitation program on coronary risk profile and health-related quality of life outcomes J Cardiopulm Rehab 20 115–21 Occurrence Handle10.1097/00008483-200003000-00005 Occurrence Handle1:STN:280:DC%2BD3c3is1eluw%3D%3D
M Korf ParticleVon EH Wagner K. Saunders (1992) ArticleTitleA chronic disease score from automated pharmacy data J Clin Epidemiol 45 197–203 Occurrence Handle10.1016/0895-4356(92)90016-G Occurrence Handle1573438
ID Nazareth MD. King (1989) ArticleTitlePrescribing of benzodiazepines by casualty officers J R Soc Med 82 276–7 Occurrence Handle1:STN:280:BiaA38fpsVQ%3D Occurrence Handle2569040
R Hulten ParticleVan AB Bakker AC Lodder KB Teeuw A Bakker HG Leufkens (2001) ArticleTitleDeterminants of change in the intention to use benzodiazepines Pharm World Sci 23 70–5 Occurrence Handle10.1023/A:1011212215640 Occurrence Handle11411448
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
van Hulten, R., Teeuw, B., Bakker, A. et al. Initial benzodiazepine use and improved health-related quality of life. Pharm World Sci 27, 41–46 (2005). https://doi.org/10.1007/s11096-005-4731-0
Issue Date:
DOI: https://doi.org/10.1007/s11096-005-4731-0