Analysis of the Benzodiazepine prescribing patterns in the primary healthcare of the Republic of Srpska

Abstract

Background: Benzodiazepines (BZDs) are very often inappropriately prescribed drugs. The aim of this study is to analyse physicians' prescribing patterns for BZD in Republic of Srpska, and to assess to what extent primary diagnosis determine the dose and the length of use of BZDs. Methods: A retrospective analysis of the physicians' prescription habits based on the database of Family Medicine Information Systems of Republic of Srpska, as well as on data from patient's medical record were performed. Patients' socio-demographic and clinical characteristics, including the data on the type and dose of BZDs prescribed, were recorded and evaluated. Results: BZDs were mostly prescribed for anxiety disorders (30.05%), for depressive disorders (17.54%), and for anxiety-depressive disorders (10.86%). A significant amount of BZDs was prescribed for non-psychiatric diagnoses (23.81%). Patients suffering from psychotic disorders were taking the highest dose of BZD and for the longest periods of time (p<0.001). Longer use of BZDs was in women (r=0.04, p<0.001), elderly (r=0.178, p<0.001), single people (r=0.12, p<0.001), those who live in urban areas (r=0.45, p<0.001) and those who were prescribed higher doses (r=0.213, p<0.001). Conclusion:A significant percentage of patients were using the BZDs for longer period of time than recommended. Strongest positive correlation was found between the dose and the length of use, which implies the addictive potential of BZDs. Since it has been noticed that prolonged use, or abuse is present regardless of the diagnosis, precaution is advised when prescribing BZDs even for acute diseases.

Prescribing pattern of benzodiazepines in outpatients without a diagnosis of mental disorders: Retrospective study

“…Studija sprovedena u Republici Srpskoj, koja je uključila i pacijente s mentalnim oboljenjima, pokazala je slične rezultate kao naša studija. Žene, stariji pacijenti i oni koji žive u urbanim sredinama koristili su BZD u dužem periodu 9 . U istoj studiji je, takođe, pokazano da ljudi koji žive sami češće koriste BZD, za razliku od naše studije gde su ljudi koji su u braku češće koristili BZD.…”

“…The study conducted in the Republic of Srpska, which also included patients with mental disorders, showed similar results as our study. Females, the elderly and patients living in urban areas used BZDs for longer periods 9 . The same study also showed that people who live alone use BZDs more often, unlike the results of our study where married persons used BZDs more frequently.…”

“…In our country, a small number of studies on the topic of prevalence and use of benzodiazepines were conducted. The available data 9 , we came across, reveal a high prevalence of benzodiazepine use in the patients in the Republic of Srpska. It is to be expected that patients with mental disorders use these drugs at a higher percentage.…”

“…The study about benzodiazepine prescriptions in the Republic of Srpska (Bosnia and Herzegovina) from 2011-2018 revealed that 2.98% of all prescriptions were prescriptions for benzodiazepines. The study showed these drugs were prescribed to 10.63% of patients, and 23.81% of BZDs were prescribed for non-psychiatric diagnoses 9 .…”

The Characteristics of Benzodiazepine Prescribing in the Republic of Srpska, Bosnia and Herzegovina

“…Recommendations are that in these conditions BZDs are used only in case of agitation. A study conducted in the Republic of Srpska found that as many as a quarter of BZDs were prescribed for non-psychiatric diagnoses such as musculoskeletal diseases, followed by epilepsy, hypertension, arrhythmias, and chest pain [ 5 ]. Maric et al found that, in South-Eastern Europe, as many as 81.9% of patients were discharged from psychiatric clinics with a high dose of BZDs (equivalent to 5 mg lorazepam) [ 6 ].…”