Longitudinal patterns of new Benzodiazepine use in the elderly

Bartlett, Gillian; Abrahamowicz, Michał; Tamblyn, Robyn; Grad, Roland; Čapek, R.; Berger, Roxane du

doi:10.1002/pds.908

Cited by 50 publications

(52 citation statements)

References 44 publications

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“…These finding confirm other studies in Norway and elsewhere, some of which are a decade old. [15][16][17][18] We may conclude that there has been little progress in this area.…”

Section: Discussionmentioning

confidence: 99%

Benzodiazepine and z-hypnotic use in Norwegian elderly, aged 65-79

Berg¹

2012

Nor J Epidemiol

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Purpose: Benzodiazepines/z-hypnotics (BZD-Z) guidelines suggest that elderly people ought to use anxiolytic benzodiazepines (BZD) and z-hypnotics only at low dose and only for a short time, and that hypnotic BZD not should be used at all. Since the elderly aged 65-79 tend to be recently retired but still in relatively good health, they may have different needs for BZD-Z than those older or younger. Our objective is to examine BZD-Z use in this age group. Methods: The study population consisted of Norwegians, aged 65-79, who filled prescriptions for anxiolytic BZD, hypnotic BZD and/or z-hypnotics in [2004][2005][2006][2007][2008][2009]. The quantities prescribed were in daily defined doses (DDD), and 100 DDD/year was deemed excessive. Results: More than a quarter of the population received at least one BZD-Z prescription each year. Half of those received more than 100 DDD/year and a quarter received over 250 DDD/year, with these proportions increasing year by year. All three subgroups of BZD-Z showed increasing use with age and all except anxiolytic BZD showed increasing proportions of users using more than 100 DDD/year with age. Conclusions: Substantial numbers of elderly aged 65-79 receive prescriptions for BZD-Z, more with increasing age, and greater amounts per user. Guidelines are clearly ignored. While a rigid enforcement of guidelines/rules is not the answer, allowing the status quo to continue shows lack of respect for guidelines.

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“…These finding confirm other studies in Norway and elsewhere, some of which are a decade old. [15][16][17][18] We may conclude that there has been little progress in this area.…”

Section: Discussionmentioning

confidence: 99%

Benzodiazepine and z-hypnotic use in Norwegian elderly, aged 65-79

Berg¹

2012

Nor J Epidemiol

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“…[1][2][3] Their use has been linked to serious adverse events such as residual daytime sedation, cognitive impairment, fall-related injuries including hip fractures, and motor vehicle collisions, particularly when combined with other drugs or alcohol. [4][5][6][7][8] An important but often overlooked issue is that longterm use of benzodiazepines can lead to dependence.…”

Section: Introductionmentioning

confidence: 99%

Initiation of Benzodiazepines in the Elderly After Hospitalization

et al. 2007

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“…This study in a large representative sample of Belgian nursing home residents provides long-awaited information on indications and dosages of benzodiazepines [33]. Actual daily dosages were compared to the geriatric upper limit, a pragmatic threshold determined from authoritative international pharmaceutical sources.…”

Section: Originality Of the Studymentioning

confidence: 99%

Benzodiazepine use in Belgian nursing homes: a closer look into indications and dosages

Bourgeois

Elseviers

Azermai

et al. 2011

Eur J Clin Pharmacol

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AIM:(i)To describe the prevalence of benzodiazepine use in Belgian nursing homes, with specific attention to indications and dosages.(ii)To compare actual and recommended dosages of benzodiazepines for anxiety and insomnia.(iii)To explore the risk profile for chronic benzodiazepine use in institutionalised older adults. METHODS:Medication charts of 1730 residents from 76 nursing homes in Belgium were collected and analysed, using the ATC classification. Drug name, indication and daily dosage were recorded. From authoritative international sources, we extracted for each drug and each indication a daily dosage recommended not to exceed in older adults, for comparison with observed actual dosages. RESULTS:Among the chronic BZD/Z users (50% of the residents), the leading indication was 'insomnia' (59% of the users) followed by 'anxiety' (17%) and 'unrest' (10%). In the chronic prescriptions of BZD/Zs indicated for insomnia, the actual daily dose exceeded the geriatric upper limit: with lormetazepam in 95% ,zolpidem in 82%, zopiclone in 78% and lorazepam in 35% of the prescriptions. In anxiety, daily doses also exceeded the limit but not to the same extend.Multivariate analysis showed BZD/Z use was positively associated with pain (OR 1.58 CI95% 1.27-1.97), constipation ) and depression (OR 1.68 CI95% 1.35-2.08). Residents with dementia were less likely of receiving a BZD/Z (OR 0.60 CI95% 0.48-0.74). CONCLUSION:Efforts to reduce the use of BZD/Zs in nursing homes should concentrate on insomnia, with interventions aimed to reduce too high prevalence of chronic use and too high daily dosages in this indication.3

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Longitudinal patterns of new Benzodiazepine use in the elderly

Abstract: Long periods of Benzodiazepine use are frequent among Quebec elderly. The evidence of increasing dose, particularly for older women, and long-duration of use has important implications for clinicians.

Cited by 50 publications

References 44 publications

Benzodiazepine and z-hypnotic use in Norwegian elderly, aged 65-79

Benzodiazepine and z-hypnotic use in Norwegian elderly, aged 65-79

Initiation of Benzodiazepines in the Elderly After Hospitalization

Benzodiazepine use in Belgian nursing homes: a closer look into indications and dosages

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