Correlates of Potentially Inappropriate Prescriptions of Benzodiazepines among Older Adults: Results from the ESA Study

Abstract

ESA study data were paired with Quebec medical and pharmaceutical services records to document potentially inappropriate benzodiazepines (Bzs) prescriptions among community-dwelling adults aged 65 and older. Results indicate that 32 per cent of respondents took a mean daily dose of 6.1 mg of equivalent diazepam for, on average, 205 days per year. Almost half (48%) of Bzs users received a potentially inappropriate benzodiazepine prescription at least once during the year preceding the survey. About 23 per cent received at least one concomitant prescription of a Bz and another drug that could result in serious interaction. In addition, individuals aged 75 and older were more likely to receive Bzs for a longer period of time than those aged 65-74. Number of pharmacies used was associated with inappropriate Bzs prescriptions. Our results argue in favour of a more integrated health services system, including a regular review of older adults' drug regimens.

Benzodiazepine use and associated factors in elderly in the city of Dourados, MS, Brazil

“…This fact was also reported by some researchers 9,15,16,18,23 . However, other studies have confirmed the information on medications in electronic data records 19,21,24 . Regarding the recall period for the use of medications, respondents were asked about the use of the medications in the past 15 days.…”

“…In addition, the different periods of drug use and the sample allocation can partly explain the quantitative differences in BZD use in these studies. Another aspect to be evaluated is the temporal question, that is, information collected before 2000 7,15,16,18,21,25 appear to show higher prevalence of BZD use than more recent studies 17,23 , except for the study of Préville et al than was collected in 2005-2006 and presented a prevalence of 32% 24 . The present investigation trained interviewers and assessed the use of drugs by checking the prescription or packaging of medications.…”

“…The use of BZD increased significantly with aging. Elderly aged prevalence rate of 32.0% 24 was obtained by means of personal interviews and confirmation of patient's records in the 12 months preceding the survey through the national health security number. These different results can be explained by the behavior of prescribers and some population characteristics evaluated such as the access to health services, epidemiology profile and social and cultural characteristics 17 .…”

“…In other studies, the period included two previous weeks 16,18 , lately 7 , now 17,23 , in the last 90 days 15 . Other commonly used drugs were lorazepam in some regions of the United States and Canada 16,18,21,23,24,26 . As it can be seen, there are different medical prescriptions for elderly people, and in Brazil, the availability of clonazepam and diazepam through the Unified Health System (SUS) may contribute to the greater use of these drugs.…”

Uso de benzodiazepínicos entre idosos: o alívio de "jogar água no fogo", não pensar e dormir

“…Apesar disso, a prevalência do seu consumo nesse segmento etário mantém-se muito elevada -cerca de 30% -, muitas vezes cronicamente, por muitos anos, 5 sendo ainda maior entre idosos mais velhos. 6,7 No Brasil, pessoas idosas são consumidoras frequentes de BZD, como evidenciam estudos epidemiológicos desenvolvidos em diferentes populações, sejam elas residentes em comunidade, com prevalência estimada de 22%, 8 ou usuárias de serviços de saúde, cuja prevalência chega a 30%. 9 Estudos qualitativos demonstram que usuários crônicos de BZD podem desenvolver dependência física e psicológica, conferindo a esses medicamentos atributos que suplantam aqueles decorrentes de sua ação farmacológica.…”