Benzodiazepine prescribing in elderly Australian general practice patients

Abstract

Objective: The use of benzodiazepines by elderly people is of limited therapeutic benefit and increases the risk of adverse events. This study aimed to examine the extent to which benzodiazepines are prescribed for elderly Australians. Methods: Data for 3,970 individuals aged 65 years or more were extracted from a general practice database. Benzodiazepine prescriptions for 2002 were reviewed. Results: Overall, 16% (95% CI 11–21%) of elderly patients had at least one benzodiazepine prescription. Females were almost twice as likely as males to be prescribed a benzodiazepine and prescription prevalence increased with age. Conclusions: Despite risks, benzodiazepines are widely prescribed for the elderly. Limited availability and cost of alternative therapies and pressures on the primary care system in Australia may contribute to their continued overuse. Implications: The prescribing of benzodiazepines for elderly Australians needs to be reduced by better managing sleep and anxiety problems.

Primary health care practitioner perspectives on the management of insomnia: a pilot study

“…These constraints include high patient volume, lack of clear referral pathways for sleep psychologists and lack of public health subsidy for sleep-related psychological treatment for many instances (Dollman et al 2003).These constraints serve as a disincentive for primary care doctors to delve deeply into the psychosocial domains of the patient's chronic sleep complaint. So while GPs do not want to readily prescribe hypnotics for chronic insomnia patients, they often still do due to health-system constraints and/or having inadequate training to address the insomnia-related psychosocial issues (Windle et al 2007). As a result the management of chronic insomnia is still lagging behind evidence-based recommendations.…”

“…This disparity may extend further into the treatment recommendations where there is an assumption that insomnia patients prefer pharmacotherapy (Dollman et al 2003;Dyas et al 2010). The over-use of pharmacotherapy may also result from: the anticipated difficulty in persuading patients to cease hypnotics (Iliffe et al 2004); primary care practitioners being not adequately trained to deal with patients' psychosocial issues; or a health care system ill-structured for managing insomnia non-pharmacologically (Windle et al 2007). …”

Fatores associados ao uso de psicotrópicos por idosos residentes no Município de São Paulo

“…A higher prevalence was reported for European countries where the prescription of antipsychotic drugs predominated (5)(6) . The prevalence of these medications, mainly benzodiazepines, ranges from 9.3% to 37.6% among elderly individuals living in the community (1,(7)(8)(9) . An investigation conducted within the Brazilian elderly population reports a consumption of benzodiazepines at 21.7% for more than 12 months (10) .…”

Patterns of chronic benzodiazepine use in the elderly

“…The prevalence was even higher (21.7%) in an elderly community sample of residents of the city of Bambuí, Minas Gerais, Brazil 21 . Prevalence rates in other countries ranged from 16% in Australia 22 to 31% in Finland 7 and 36% in Canada 6 . These results are particularly important because there are guidelines that classify the BZD use as inappropriate, particularly because of side effects in the elderly 23 .…”