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Purpose: To examine the effects of various medical conditions and medications on subsequent motor vehicle injuries (MVIs)., Method: The National Population Health Survey, a large, nationally representative, longitudinal study of Canadians, included self-reported medical conditions of asthma, arthritis/rheumatism, back problems excluding arthritis, high blood pressure, migraine headaches, diabetes, heart disease and distress, and medication use during the past month for asthma, high blood pressure, diabetes, heart, codeine/pethidine (Demerol)/morphine, other pain relievers, antidepressants, tranquilizers, and sleeping medication. Path analyses were used to examine the odds of subsequent MVI for different medical conditions and medication use reported prior to the MVI (in the previous wave of the survey) while controlling for age and sex., Results: Increased odds of subsequent MVIs were found for asthma (odds ratio [OR]: 1.864, 95% confidence interval [CI]: 1.281, 2.713), arthritis/rheumatism (OR: 1.659, 95% CI: 1.163, 2.365), back problems (OR: 2.169, 95% CI: 1.624, 2.895), and migraines (OR: 1.631, 95% CI: 1.125, 2.364) but not for high blood pressure (OR: 1.435, 95% CI: 0.944, 2.181), diabetes (OR: 1.479, 95% CI: 0.743, 2.944), heart disease (OR: 2.627, 95% CI: 0.941, 7.334) or distress (OR: 1.153, 95% CI: 0.840, 1.581). Except for migraine with codeine/pethidine/morphine, this effect persisted regardless of whether medication was used to treat the condition. Respondents who reported using certain medications, namely, codeine/pethidine/morphine (OR: 2.215, 95% CI: 1.274, 3.850), other pain medication (OR: 1.630, 95% CI: 1.242, 2.139), antidepressants (OR: 2.664. 95% CI: 1.602, 4.429), and sleeping medication (OR: 2.059, 95% CI: 1.161, 3.651), had increased odds of subsequent MVI, independent of related medical condition, whereas tranquillizers showed no increased odds of subsequent MVIs., Conclusions: This study suggests that the relationship between medical conditions, medications, and MVIs is complex but consistent with other studies.

Background: This study aims to better understand the contributions of occupation and work organization conditions to the development of chronic psychotropic drugs use among workers in Canada., Methods: The study is based on a secondary analysis of the longitudinal data of the National Population Health Survey (NPHS) of Statistics Canada which includes five cycles from 1994-1995 to 2002-2003. A panel of 6585 people from 15 to 55 years old and employed at cycle 1 and nested in 1413 neighbourhoods was selected. Multilevel models of regression were estimated on three levels: repeated measures (level 1=24,785 observations) were nested in the individuals (level 2=6585 individuals) and the individuals nested in the local communities (level 3=1413 neighborhoods)., Results: The prevalence of multiple episodes (two episodes and more between cycle 1 and cycle 5) of psychotropic drugs use was 6.7% (95%CI=6.0-7.4%). Only occupation and the number of working hours showed a significant contribution. Family and individual variables like marital status and personality traits (locus of control and sense of coherence) had a significant contribution, in addition to time, gender, age, physical health, number of cigarettes and stressful childhood events., Conclusion: Work contributes weakly to the risk of chronic psychotropic drugs use, whereas individual characteristics make a much more important contribution to the phenomenon.

Background and Aims: Data on antipsychotic use were collected in two Canadian long-term care (LTC) facilities. During the one-year study, residents in one facility were relocated to a new facility, allowing examination of the changes in antipsychotic use associated with relocation., Method: A comparative descriptive design was used. Pharmacy and chart data on antipsychotic use were gathered for three separate one-month periods during one year. Data were collected both in a facility experiencing relocation of all residents to a new facility, and in a facility not undergoing relocation. The three one-month data collection periods covered a one-month period before the relocation, immediately after the relocation, and six months after the relocation., Results: In the facility not experiencing relocation, an average of 31.3% of all residents were receiving antipsychotics. Residents in this facility received antipsychotics for an average length of 0.81 years, and 20.8% of all antipsychotic prescriptions reflected dose reductions within six months of the start of the prescription. Only 8.1% of prescriptions had accompanying documentation on the behavioral indication for the use of antipsychotics. A total of 73.4% of all antipsychotics were 'atypical' antipsychotics, and 13.5% of all antipsychotic prescriptions were written as 'p.r.n.' (as needed). While the use of antipsychotics remained relatively constant in the non-relocation facility (between 30.3% and 33.1% of all residents), the percentage of residents receiving antipsychotics in the facility experiencing a relocation climbed significantly; from 21.5% six months before the move, to 32.6% immediately after the move, to 36.9% six months after the move., Conclusion: These findings, when compared with the U.S. standards on antipsychotic use (OBRA), suggest the need for additional research on antipsychotic use in Canadian LTC facilities.

Although many studies of sedative-hypnotic drug use have been performed in Canada, there has been no national study of the use of these drugs. We have attempted to correct this deficit in our knowledge by using data from an international survey of health care utilization performed in 1968-9 and from the Canada Health Survey (1978-9), the Health Promotion Survey (1985) and the National Alcohol and Other Drugs Survey (1989) to examine sedative-hypnotic use among individuals aged 15 or more. The results suggest that the use of these drugs in Canada is about average for an industrialized society. Several socioeconomic and health care correlates of sedative-hypnotic use were found. The rate of use of these drugs was higher among women, the elderly, separated, divorced or widowed individuals, those who had a secondary school education or less, individuals with a low family income, the retired, and the unemployed. Among women, higher rates of use were reported by those whose main activity was keeping house (as compared with those who were employed outside the home) and by those who lived alone. Higher rates of use were also found for individuals who had consulted a physician or been hospitalized recently, individuals taking multiple drugs, those who scored highly on an anxiety scale, persons in whom negative feelings predominated, and those who had experienced a high frequency of psycho-physiological symptoms of anxiety and depression. From a regional point of view, the highest rates of use for women were consistently reported from Quebec, while the lowest were consistently found in the Prairie provinces. No consistent pattern was found for men.

It has been frequently suggested that physicians' indiscriminate prescribing has caused the high level of patient use of benzodiazepines. To determine whether this was true at Ottawa Civic Hospital's Family Medicine Centre, patient charts of women aged 45 to 65-the age-sex group that received the highest number of new prescriptions for diazepam (Valium) or oxazepam (Serax) - were studied. Middle-aged women who received a new prescription for one of these drugs visited the office significantly more often, had more marital problems, and experienced significantly more life crisis situation than a control group of nonrecipients. These results suggest that the high rate of prescribing is related to high levels of reported life stress in middle-aged women. Further studies in other centers are needed to conclusively disprove the popularly held idea that benzodiazepines are indiscriminately prescribed by physicians.