Older adults’ perceptions of deprescribing chronic benzodiazepines

Choi, Jae Won; Vordenberg, Sarah E.

doi:10.1016/j.japh.2021.04.003

Cited by 6 publications

(9 citation statements)

References 22 publications

(27 reference statements)

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“…For some this was the availability of blood tests to ensure certain parameters such as blood cholesterol, remained stable even after stopping the medication, whereas for others it was about considering this process as a trial with the possibility of going back on their medication should this be necessary 39,47 . Some preferred a weaning period before cessation of the medication and withdrawal of medication one at a time 12,48 . Those taking antidepressants expressed the tapering process would also be facilitated if at first prescription they are informed the length of treatment would be of a limited duration 49 .…”

Section: Resultsmentioning

confidence: 99%

“…Fear is another reason quoted by older people for resistance to de‐prescribing. This is often the fear of symptoms returning following cessation of medication, especially, antidepressants and benzodiazepine hypnotics 46,48,49,52,53 . Some older adults had bad experiences on stopping medication previously and so are reluctant to de‐prescribing 39,49,52,53 .…”

Section: Resultsmentioning

confidence: 99%

“…12,40 3.6.3 | Monitoring (n = 7) Older people were more willing to have a medication stopped if there was a monitoring process in place. 12,39,[46][47][48] For some this was the availability of blood tests to ensure certain parameters such as blood cholesterol, remained stable even after stopping the medication, whereas for others it was about considering this process as a trial with the possibility of going back on their medication should this be necessary. 39,47 Some preferred a weaning period before cessation of the medication and withdrawal of medication one at a time.…”

Section: Relationship Between Patd/rpatd Items and The Willingness To...mentioning

confidence: 99%

“…39,47 Some preferred a weaning period before cessation of the medication and withdrawal of medication one at a time. 12,48 Those taking antidepressants expressed the tapering process would also be facilitated if at first prescription they are informed the length of treatment would be of a limited duration. 49 Carers also expressed monitoring the process of de-prescribing was important and they would want a discussion with the HCP especially, as they spend most time with the older adults and would be in a good position to be involved.…”

Section: Relationship Between Patd/rpatd Items and The Willingness To...mentioning

confidence: 99%

“…This is often the fear of symptoms returning following cessation of medication, especially, antidepressants and benzodiazepine hypnotics. 46,48,49,52,53 Some older adults had bad experiences on stopping medication previously and so are reluctant to de-prescribing. 39,49,52,53 One study noted that older adults also feared missing out on further benefits if they stopped their medications.…”

Section: Relationship Between Patd/rpatd Items and The Willingness To...mentioning

confidence: 99%

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Attitudes of older adults and their carers towards de‐prescribing: A systematic review

et al. 2022

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Polypharmacy is often referred to as the concurrent use of multiple medications by one individual. 1 With an ageing population and in turn people living with more comorbidities, polypharmacy is increasing in older adults. 1,2 Polypharmacy can be harmful in this population. There are changes in drug absorption, distribution, metabolism and excretion with increasing age mainly as a result of reduction in body weight, renal excretion and liver enzyme function. 3 Altered pharmacokinetics can make older people more susceptible to side effects, and there is increased risk of drug interactions. 3 Polypharmacy can also lead to poor medication adherence, impaired quality of life and potentially inappropriate prescribing whereby the risks of the medication outweigh the benefits. 1,5 It has been

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Relationship Between Patd/rpatd Items and The Willingness To...mentioning

confidence: 99%

Section: Relationship Between Patd/rpatd Items and The Willingness To...mentioning

confidence: 99%

Section: Relationship Between Patd/rpatd Items and The Willingness To...mentioning

confidence: 99%

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Attitudes of older adults and their carers towards de‐prescribing: A systematic review

et al. 2022

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Benzodiazepine Receptor Agonists Use and Cessation Among Multimorbid Older Adults with Polypharmacy: Secondary Analysis from the OPERAM Trial

et al. 2023

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Background Benzodiazepine receptor agonists (BZRAs) are commonly prescribed in older adults despite an unfavorable risk–benefit ratio. Hospitalizations may provide a unique opportunity to initiate BZRA cessation, yet little is known about cessation during and after hospitalization. We aimed to measure the prevalence of BZRA use before hospitalization and the rate of cessation 6 months later, and to identify factors associated with these outcomes. Methods We conducted a secondary analysis of a cluster randomized controlled trial (OPtimising thERapy to prevent Avoidable hospital admissions in the Multimorbid elderly [OPERAM]), comparing usual care and in-hospital pharmacotherapy optimization in adults aged 70 years or over with multimorbidity and polypharmacy in four European countries. BZRA cessation was defined as taking one or more BZRA before hospitalization and not taking any BZRA at the 6-month follow-up. Multivariable logistic regression was performed to identify factors associated with BZRA use before hospitalization and with cessation at 6 months. Results Among 1601 participants with complete 6-month follow-up data, 378 (23.6%) were BZRA users before hospitalization. Female sex (odds ratio [OR] 1.52 [95% confidence interval 1.18–1.96]), a higher reported level of depression/anxiety (OR up to 2.45 [1.54–3.89]), a higher number of daily drugs (OR 1.08 [1.05–1.12]), use of an antidepressant (OR 1.74 [1.31–2.31]) or an antiepileptic (OR 1.46 [1.02–2.07]), and trial site were associated with BZRA use. Diabetes mellitus (OR 0.60 [0.44–0.80]) was associated with a lower probability of BZRA use. BZRA cessation occurred in 86 BZRA users (22.8%). Antidepressant use (OR 1.74 [1.06–2.86]) and a history of falling in the previous 12 months (OR 1.75 [1.10–2.78]) were associated with higher BZRA cessation, and chronic obstructive pulmonary disease (COPD) (OR 0.45 [0.20–0.91]) with lower BZRA cessation. Conclusion BZRA prevalence was high among included multimorbid older adults, and BZRA cessation occurred in almost a quarter of them within 6 months after hospitalization. Targeted BZRA deprescribing programs could further enhance cessation. Specific attention is needed for females, central nervous system-acting co-medication, and COPD co-morbidity. Registration ClinicalTrials.gov identifier: NCT02986425. December 8, 2016. Supplementary Information The online version contains supplementary material available at 10.1007/s40266-023-01029-1.

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Barriers and enablers to deprescribing of older adults and their caregivers: a systematic review and meta-synthesis

Bolt,

Abdoulrezzak,

Inglis

2023

Eur Geriatr Med

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Older adults’ perceptions of deprescribing chronic benzodiazepines

Cited by 6 publications

References 22 publications

Attitudes of older adults and their carers towards de‐prescribing: A systematic review

Attitudes of older adults and their carers towards de‐prescribing: A systematic review

Benzodiazepine Receptor Agonists Use and Cessation Among Multimorbid Older Adults with Polypharmacy: Secondary Analysis from the OPERAM Trial

Barriers and enablers to deprescribing of older adults and their caregivers: a systematic review and meta-synthesis

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