Long term benzodiazepine use for insomnia in patients over the age of 60: discordance of patient and physician perceptions.
Long term benzodiazepine use for insomnia in patients over the age of 60: discordance of patient and physician perceptions.
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DOI：
10.1186/1471-2296-3-9
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发表时间：
2002-05-08
影响因子：
2.9
通讯作者：
Upshur RE
中科院分区：
文献类型：
--
作者：
Mah L;Upshur RE
这项研究的目的是确定和比较患者和医生对长期使用苯二氮卓类药物治疗老年人失眠的益处和风险的看法。一项横断面研究(书面调查)在加拿大多伦多的一个学术初级保健团体诊所进行。参与者是93名60岁以上使用苯二氮类药物治疗失眠的患者和25名医生，其中包括睡眠专家、家庭医生和家庭医学住院医生。主要的结果衡量标准是对收益的感知和根据对调查中不同项目的回答的平均值(Likert评分从1到5)计算的风险分数。患者的受益感得分显著高于医生(3.85vs.2.84，p<；0.001，95%CI 0.69，1.32)。患者对风险的平均知觉得分显著低于医生(2.21vs.3.63，p<；0.001，95%CI1.07，1.77)。对于长期使用苯二氮卓类药物治疗失眠的益处和风险的看法，老年患者和他们的医生之间存在着显著的分歧。挑战是在现有证据的背景下公开讨论这些看法，以作出协作和知情的决定。
The aim of this study was to determine and compare patients' and physicians' perceptions of benefits and risks of long term benzodiazepine use for insomnia in the elderly. A cross-sectional study (written survey) was conducted in an academic primary care group practice in Toronto, Canada. The participants were 93 patients over 60 years of age using a benzodiazepine for insomnia and 25 physicians comprising sleep specialists, family physicians, and family medicine residents. The main outcome measure was perception of benefit and risk scores calculated from the mean of responses (on a Likert scale of 1 to 5) to various items on the survey. The mean perception of benefit score was significantly higher in patients than physicians (3.85 vs. 2.84, p < 0.001, 95% CI 0.69, 1.32). The mean perception of risk score was significantly lower in patients than physicians (2.21 vs. 3.63, p < 0.001, 95% CI 1.07, 1.77). There is a significant discordance between older patients and their physicians regarding the perceptions of benefits and risks of using benzodiazepines for insomnia on a long term basis. The challenge is to openly discuss these perceptions in the context of the available evidence to make collaborative and informed decisions.