{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:53:48Z","timestamp":1769129628378,"version":"3.49.0"},"reference-count":0,"publisher":"Canadian Geriatrics Society","issue":"1","license":[{"start":{"date-parts":[[2023,3,2]],"date-time":"2023-03-02T00:00:00Z","timestamp":1677715200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can Geriatr J"],"abstract":"<jats:p>Background\nThere is growing evidence of harm associated with trazodone and nonbenzodiazepine sedative hypnotics (e.g., zopiclone); however, their comparative risk of harm is unknown. \nMethods\nWe conducted a retrospective cohort study with linked health administrative data, which enrolled older ( \u226566 years old) nursing home residents living in Alberta, Canada, between December 1, 2009, and December 31, 2018; the last follow-up date was June 30, 2019. We compared the rate of injurious falls and major osteoporotic fractures (primary outcome) and all-cause mortality (secondary outcome) within 180 days of first prescription of zopiclone or trazodone with cause-specific hazard models and inverse probability of treatment weights to control for confounding; primary analysis was intention-to-treat and secondary analysis was per-protocol (i.e., residents censored if dispensed the other exposure drug).\nResults\nOur cohort included 1,403 residents newly dispensed trazo-done and 1,599 residents newly dispensed zopiclone. At cohort entry, the mean resident age was 85.7 (standard deviation [SD] 7.4), 61.6% were female, and 81.2% had dementia. New zopi-clone use was associated with similar rates of injurious falls and major osteoporotic fractures (intention-to-treat-weighted hazard ratio 1.15, 95% confidence interval [CI] 0.90-1.48; per-protocol-weighted hazard ratio 0.85, 95% CI 0.60-1.21) and all-cause mortality (intention-to-treat-weighted hazard ratio 0.96, 95% CI 0.79-1.16; per-protocol-weighted hazard ratio 0.90, 95% CI 0.66-1.23) compared to trazodone.\nConclusions\nZopiclone was associated with a similar rate of injurious falls, major osteoporotic fractures, and all-cause mortality compared to trazodone\u2014suggesting one medication should not be used in lieu of the other. Appropriate prescribing in-itiatives should also target zopiclone and trazodone.\u00a0<\/jats:p>","DOI":"10.5770\/cgj.26.622","type":"journal-article","created":{"date-parts":[[2023,3,22]],"date-time":"2023-03-22T16:13:11Z","timestamp":1679501591000},"page":"9-22","source":"Crossref","is-referenced-by-count":3,"title":["Comparative Risk of Harm Associated with Zopiclone or Trazodone Use in Nursing Home Residents: a Retrospective Cohort Study in Alberta, Canada"],"prefix":"10.5770","volume":"26","author":[{"given":"Jennifer A.","family":"Watt","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan E.","family":"Bronskill","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meng","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik","family":"Youngson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne","family":"Ho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brenda","family":"Hemmelgarn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon E.","family":"Straus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Gruneir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3968","published-online":{"date-parts":[[2023,3,2]]},"container-title":["Canadian Geriatrics Journal"],"original-title":[],"link":[{"URL":"https:\/\/cgjonline.ca\/index.php\/cgj\/article\/download\/622\/882","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/cgjonline.ca\/index.php\/cgj\/article\/download\/622\/893","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/cgjonline.ca\/index.php\/cgj\/article\/download\/622\/882","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,22]],"date-time":"2023-03-22T16:13:11Z","timestamp":1679501591000},"score":1,"resource":{"primary":{"URL":"https:\/\/cgjonline.ca\/index.php\/cgj\/article\/view\/622"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,2]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,3,2]]}},"URL":"https:\/\/doi.org\/10.5770\/cgj.26.622","relation":{},"ISSN":["1925-8348"],"issn-type":[{"value":"1925-8348","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,2]]}}}