{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T07:16:38Z","timestamp":1773213398786,"version":"3.50.1"},"reference-count":52,"publisher":"BMJ","issue":"9","funder":[{"DOI":"10.13039\/501100006095","name":"Helse S\u00f8r-\u00d8st RHF","doi-asserted-by":"publisher","award":["Prosjektnummer 2011016"],"award-info":[{"award-number":["Prosjektnummer 2011016"]}],"id":[{"id":"10.13039\/501100006095","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005416","name":"Norges Forskningsr\u00e5d","doi-asserted-by":"publisher","award":["NFR-nummer 256431"],"award-info":[{"award-number":["NFR-nummer 256431"]}],"id":[{"id":"10.13039\/501100005416","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,8,20]]},"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Timely recognition of medication misuse and dependence is crucial to avoid both adverse drug events and increasing health expenditure. Yet the detection of these disorders in older people remains challenging due to the paucity of evidence on characteristics of patients at risk. This study investigates sociodemographic, pharmacological and clinical characteristics and factors associated with prolonged medication use, misuse and dependence in hospitalised older patients, focusing on three commonly prescribed central nervous system depressants (CNSDs): opioid analgesics, benzodiazepines and z-hypnotics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>A prospective, cross-sectional study complying with the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Somatic departments of the Akershus University Hospital, Norway.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>246 patients aged 65\u201390 were included.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcome measures<\/jats:title>\n                  <jats:p>Prolonged use was defined as using CNSDs for \u22654 weeks. Misuse and dependence were assessed with the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition criteria for substance abuse and dependence. We used descriptive statistics to report patients\u2019 characteristics and logistic regression to demonstrate factors associated with prolonged use, and misuse or dependence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Forty per cent of participants reported using CNSDs for \u22654 weeks. The odds of prolonged use were higher for patients aged 75\u201384 (OR=2.32, 95% CI 1.16 to 4.65) and \u226585 (OR=3.33, 95% CI 1.25 to 8.87) vs &lt;75 years, for pain intensity (OR=1.02, 95% CI 1.01 to 1.04), and polypharmacy versus no polypharmacy (OR=5.16, 95% CI 2.13 to 12.55). The odds were lower for patients who completed secondary education (OR=0.33, 95% CI 0.13 to 0.83) compared with those with only basic education. Factors associated with misuse or dependence were pain intensity (OR=1.02, 95% CI 1.01 to 1.04) and concurrent use of \u22652 CNSDs (OR=3.99, 95% CI 1.34 to 11.88).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>CNSD overuse is prevalent among hospitalised older patients, despite clear guidelines and recommendations. Our findings underline a need for stronger focus on responsible prescribing, timely detection and prevention of this issue, with special attention towards older patients, those with enhanced pain, polypharmacy and\/or concurrent use of several CNSDs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT03162081\">NCT03162081<\/jats:ext-link>.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-031483","type":"journal-article","created":{"date-parts":[[2019,9,6]],"date-time":"2019-09-06T05:09:29Z","timestamp":1567746569000},"page":"e031483","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":24,"title":["Sociodemographic, clinical and pharmacological profiles of medication misuse and dependence in hospitalised older patients in Norway: a prospective cross-sectional study"],"prefix":"10.1136","volume":"9","clinical-trial-number":[{"clinical-trial-number":"nct03162081","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2277-7585","authenticated-orcid":false,"given":"Socheat","family":"Cheng","sequence":"first","affiliation":[{"name":"Health Services Research Unit (H\u00d8KH), Akershus University Hospital, L\u00f8renskog, Norway"},{"name":"Institute of Clinical Medicine, Campus Ahus, University of Oslo, L\u00f8renskog, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8404-0610","authenticated-orcid":false,"given":"Tahreem Ghazal","family":"Siddiqui","sequence":"additional","affiliation":[{"name":"Health Services Research Unit (H\u00d8KH), Akershus University Hospital, L\u00f8renskog, Norway"},{"name":"Institute of Clinical Medicine, Campus Ahus, University of Oslo, L\u00f8renskog, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Gossop","sequence":"additional","affiliation":[{"name":"National Addiction Centre, King's College, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8999-5424","authenticated-orcid":false,"given":"Espen Saxhaug","family":"Kristoffersen","sequence":"additional","affiliation":[{"name":"Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway"},{"name":"Department of Neurology, Akershus University Hospital, L\u00f8renskog, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christofer","family":"Lundqvist","sequence":"additional","affiliation":[{"name":"Health Services Research Unit (H\u00d8KH), Akershus University Hospital, L\u00f8renskog, Norway"},{"name":"Institute of Clinical Medicine, Campus Ahus, University of Oslo, L\u00f8renskog, Norway"},{"name":"Department of Neurology, Akershus University Hospital, L\u00f8renskog, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,9,5]]},"reference":[{"key":"2025101812445006000_9.9.e031483.1","unstructured":"World Health Organization . 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