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An improved understanding of factors associated with the transition from new to long-term BZDR use and of temporal BZDR use trajectories is needed. We aimed to assess the proportion of long-term BZDR use (&gt;\u20096\u00a0months) in incident BZDR-recipients across the lifespan; identify 5-year BZDR use trajectories; and explore individual characteristics (demographic, socioeconomic and clinical) and prescribing-related factors (pharmacological properties of the initial BZDR, prescriber\u2019s healthcare level, and concurrent dispensing of other medications) associated with long-term BZDR use and distinct trajectories.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Our nationwide register-based cohort included all BZDR-recipients in Sweden with first dispensation in 2007\u20132013. Trajectories of BZDR use days per year were built using group-based trajectory modelling. Cox regression and multinomial logistic regression were fitted to assess the predictors of long-term BZDR use and trajectories\u2019 membership.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In 930,465 incident BZDR-recipients, long-term use increased with age (20.7%, 41.0%, and 57.4% in 0\u201317, 18\u201364, and\u2009\u2265\u200965-year-olds, respectively). Four BZDR use trajectories emerged, labelled \u2018discontinued\u2019, \u2018decreasing\u2019, \u2018slow decreasing\u2019 and \u2018maintained\u2019. The proportion of the \u2018discontinued\u2019 trajectory members was the largest in all ages, but reduced from 75.0% in the youths to 39.3% in the elderly, whereas the \u2018maintained\u2019 increased with age from 4.6% to 36.7%. Prescribing-related factors, in particular multiple BZDRs at initiation and concurrent dispensing of other medications, were associated with increased risks of long-term (<jats:italic>vs<\/jats:italic> short-term) BZDR use and developing other trajectories (<jats:italic>vs<\/jats:italic> \u2018discontinued\u2019) in all age groups.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The findings highlight the importance of raising awareness and providing support to prescribers to make evidence-based decisions on initiating and monitoring BZDR treatment across the lifespan.\n<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00228-023-03515-2","type":"journal-article","created":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T14:06:06Z","timestamp":1686319566000},"page":"1091-1105","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Factors associated with long-term benzodiazepine and Z-drug use across the lifespan and 5-year temporal trajectories among incident users: a Swedish nationwide register-based study"],"prefix":"10.1007","volume":"79","author":[{"given":"Kayoko","family":"Isomura","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinchen","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Hellner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Hasselstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Ekheden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitya","family":"Jayaram-Lindstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Lichtenstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian M.","family":"D\u2019Onofrio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Mataix-Cols","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Sidorchuk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,6,9]]},"reference":[{"key":"3515_CR1","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1016\/j.mcna.2021.08.012","volume":"106","author":"L Peng","year":"2022","unstructured":"Peng L, Morford KL, Levander XA (2022) Benzodiazepines and Related Sedatives. 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