Epidemic Use of Benzodiazepines among Older Adults in Israel: Epidemiology and Leverage Points for Improvement

Steinman, Michael A.; Low, Marcelo; Balicer, Ran D.; Shadmi, Efrat

doi:10.1007/s11606-017-4059-1

Cited by 21 publications

(19 citation statements)

References 30 publications

(47 reference statements)

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“…In agreement with our findings, BZDC increased with age in other national and international surveys 28 -30 However, our findings showed that consumption after age 60 was lower than among those in the 49-59 age stratum, a somewhat suprising fact, as older individuals are described as the leading group of BZD users in many studies 25,26. Corroborating our finding, another study showed that long-term use of sedatives increased between 2004 and 2013 driven largely by increased use among middle-aged adults31 It also bears stressing that lifetime BZDC among adolescents (2.7%) was lower than previously reported in a Brazilian study (5%)32 and in a European study (5.6%) 33.…”

Section: Discussionsupporting

confidence: 93%

Prevalence of and pathways to benzodiazepine use in Brazil: the role of depression, sleep, and sedentary lifestyle

Madruga

Paim

Palhares

et al. 2019

Braz. J. Psychiatry

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Objective:This study aimed to determine the prevalence of benzodiazepine (BZD) use in Brazil and to investigate the direct and indirect effects of alcohol consumption, sedentary lifestyle (SL), depressive symptoms (DS), and sleep dissatisfaction (SD) on BZD use.Methods:The Second Brazilian Alcohol and Drugs Survey (II BNADS) used stratified cluster probabilistic sampling to select 4,607 individuals aged 14 years and older from the Brazilian household population.Results:The lifetime and 12-month prevalence of BZD use was 9.8 and 6.1%, respectively. Older participants (age 40 and older) and women had higher rates. Alcohol use disorder, DS, and SD were significantly more prevalent in BZD users. The parallel multiple mediator model showed a positive direct effect of alcohol consumption on BZD use, with significant positive indirect effects of SL, SD, and DS as simultaneous mediators leading to higher BZD intake. Other statistically significant indirect pathways were DS alone, SD alone, and all of the above except SL.Conclusion:The prevalence of BZD use in Brazil is high compared to that of other countries. Knowledge of the main risk factors and pathways to consumption can guide prevention initiatives and underlie the development of better tailored and effective treatment strategies.

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Section: Discussionsupporting

confidence: 93%

Prevalence of and pathways to benzodiazepine use in Brazil: the role of depression, sleep, and sedentary lifestyle

Madruga

Paim

Palhares

et al. 2019

Braz. J. Psychiatry

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“…A few additional Israeli studies have reported on lack of disparities or even on pro-minority differences in care between Arabs and Jews. For example, a study of the unwarranted epidemic of benzodiazepine use in Israel, found that older Arab Israelis are much less likely to receive benzodiazepine or benzodiazepine-receptor agonists than older Jewish Israelis [ 18 ]. A national Israeli study on participation in health promotion workshops has found that although participation rates among Arabs were lower than among Jews, once enrolled in a workshop, Arabs tended to attend more meetings than Jews [ 19 ].…”

mentioning

confidence: 99%

Healthcare disparities amongst vulnerable populations of Arabs and Jews in Israel

Shadmi

2018

Isr J Health Policy Res

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The complex nature of studying health and healthcare disparities in general, and in the context of the Israeli healthcare system in particular, is depicted in two recent IJHPR articles. The first examines Emergency Department (ED) waiting times in a tertiary children’s hospital and the second examines disparities in the health care for people with schizophrenia of an ethnic-national minority. Contrary to other Israeli studies on wide disparities in health and healthcare, these studies show no disparities - ED waiting times did not differ among Arab and Jewish children and report no differences in performance of Hemoglobin A1C tests or in surgical interventions in patients with cardiovascular disease between Arabs and Jews with schizophrenia. Thus, the studies reflect areas of equitable health care delivery within the Israeli healthcare system.Future studies should account for the fact that the phenomena of health and healthcare disparities is complex and should utilize rigorous methodologies to take into consideration the various factors that may affect the manifestation of differences amongst population groups. As a result, they may help detect disparities which may otherwise be missed.

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“…Pain, agitation, worry and sadness were still found as reasons. In the other two studies, the first one shows that insomnia and anxiety were also the most frequent causes 25 and the second one reported that the diagnosis of depression was the most recurrent 26 .…”

Section: Discussionmentioning

confidence: 99%

Benzodiazepines use in elderly patients attended at a Public Pharmacy in Pernambuco Brazil

Freitas

Diniz²,

Alves

et al. 2019

AIMJ

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: The elderly people are the group that most use psychotropic drugs, due to psychiatric comorbidity and somatic conditions. In Brazil some benzodiazepines are part of the National List of Essential Medicines (RENAME) being distributed free of charge, facilitating the population access, which can lead to irrational use. Methods: Cross-sectional, descriptive research through a qualitative and quantitative study of benzodiazepine use in patients attended at the Cedro Basic Pharmacy in the city of Cedro-PE. The data collection was done with the application of a semi-structured questionnaire. The pattern of benzodiazepine use has been described through patient-reported symptomatology, therapeutic adherence, medical specialty, dose increase without medical consultation, and adverse effects reported during the drug use. Results: There was a predominance of females (58.33%). The most commonly used benzodiazepine was diazepam (66.67%). The purchase of benzodiazepine without a prescription was reported by 16.67% of the elderly interviewed and an increase in the drug dose without doctor consulting by 25% of the interviewees. Final considerations: The prescription of these drugs for the elderly, as well as the chronic use, should consider the physiological changes caused by aging and the adverse effects of these drugs in order to guarantee a safe treatment. Keywords : Aged; Psychotropic drugs; Drug utilization.

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Epidemic Use of Benzodiazepines among Older Adults in Israel: Epidemiology and Leverage Points for Improvement

Cited by 21 publications

References 30 publications

Prevalence of and pathways to benzodiazepine use in Brazil: the role of depression, sleep, and sedentary lifestyle

Prevalence of and pathways to benzodiazepine use in Brazil: the role of depression, sleep, and sedentary lifestyle

Healthcare disparities amongst vulnerable populations of Arabs and Jews in Israel

Benzodiazepines use in elderly patients attended at a Public Pharmacy in Pernambuco Brazil

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