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Table 5 Adjusted hazard ratios for Z-drug prescription and new prescriptions, GP consultations, and hospital admissions for people with dementia according to prescribed daily defined doses (DDDs) of Z-drugs

From: Adverse effects of Z-drugs for sleep disturbance in people living with dementia: a population-based cohort study

Outcome and daily defined dose prescribeda

No. events in the Z-drug cohort

No sedative-hypnotic, sleep disturbance (n = 1833)

No Z-drug, proximal GP consultation (n = 10,214)

Age, sex adjusted

Fully adjustedb

Age, sex adjusted

Fully adjustedb

Number of hospital admissionsc

 ≤ 0.5

1403

1.24 (1.10–1.39)

1.18 (1.05–1.32)

1.19 (1.07–1.31)

1.10 (1.00–1.20)

 0.6–0.9

63

1.06 (0.76–1.49)

1.22 (0.88–1.69)

1.03 (0.74–1.43)

1.10 (0.80–1.51)

 ≥ 1

472

1.35 (1.15–1.58)

1.29 (1.10–1.50)d

1.32 (1.15–1.52)

1.22 (1.06–1.39)d

Number of GP consultationsc

 ≤ 0.5

9230

1.21 (1.14–1.29)

1.10 (1.05–1.16)d

0.89 (0.85–0.94)

1.00 (0.96–1.04)

 0.6–0.9

690

1.12 (0.96–1.32)

1.10 (0.95–1.26)

0.83 (0.71–0.97)

1.02 (0.88–1.17)

 ≥ 1

4823

1.23 (1.12–1.34)

1.16 (1.08–1.25)d

0.91 (0.84–0.98)

1.06 (0.99–1.13)

Incident antipsychotic prescription

 ≤ 0.5

214

2.08 (1.64–2.62)

2.00 (1.54–2.61)d

3.09 (2.56–3.74)

3.31 (2.69–4.07)d

 0.6–0.9

18

3.35 (2.04–5.50)

2.75 (1.57–4.81)d

5.15 (3.19–8.32)

4.82 (2.81–8.25)d

 ≥ 1

99

4.05 (3.10–5.31)

3.56 (2.61–4.85)d

5.81 (4.55–7.42)

5.82 (4.44–7.63)d

Incident antidepressant prescription

 ≤ 0.5

124

1.25 (1.14–1.37)

1.16 (1.05–1.28)d

2.47 (1.91–3.19)

2.39 (1.90–2.99)d

 0.6–0.9

8

1.20 (0.83–1.73)

1.13 (0.76–1.68)

2.67 (1.19–5.99)

3.00 (1.49–6.01)

 ≥ 1

40

1.37 (1.17–1.61)

1.31 (1.11–1.54)d

3.47 (2.32–5.18)

2.93 (2.04–4.19)d

Incident antibiotic prescription

 ≤ 0.5

583

1.43 (1.27–1.63)

1.30 (1.13–1.49)d

1.25 (1.14–1.37)

1.16 (1.05–1.28)d

 0.6–0.9

27

1.36 (0.93–2.00)

1.20 (0.79–1.81)

1.20 (0.83–1.73)

1.13 (0.76–1.68)

 ≥ 1

181

1.57 (1.32–1.88)

1.46 (1.21–1.76)d

1.37 (1.17–1.61)

1.31 (1.11–1.54)d

  1. Abbreviations: HR hazard ratio, CI confidence interval, GP general practitioner
  2. aThe reference group for all comparisons is no Z-drug prescription. Most patients assigned to the ‘0.6–0.9 DDD’ Z-drug group were prescribed 3.75 mg zopiclone with instructions similar to ‘TAKE ONE OR TWO AT NIGHT’
  3. bAdjusted for all covariates listed in Table 1
  4. cEstimates provided are rate ratios (95% confidence intervals)
  5. dFully adjusted HR remaining statistically significant after controlling the false discovery rate to < 5% (based on 37 tests; 11 outcomes with three dose categories and two outcomes with two dose categories)