Study on medication prescription in the elderly population: benzodiazepine use and potential drug interactions

Abstract

Background Prescription of medications for elderly individuals is complex, potentially involving polypharmacy, drug interactions, and inappropriate medication. Notable among the medications are benzodiazepines, whose long-term use is common and growing among the elderly population. Objective This study aimed to evaluate the occurrence of potential drug interactions (PDI) in elderly community-dwelling patients who use benzodiazepines. Method Cross-sectional study, conducted via household survey, with 73 elderly persons in Juiz de Fora, MG, Brazil. The search and classification of PDIs was carried out using the Micromedex® system. Results The prevalence of benzodiazepine use in this population was 18.3% (95% CI, 15.2-21.6). The use of benzodiazepines was associated with polypharmacy (p<0.01; PR 3.03; 95% CI, 1.79-5.26). A total of 157 PDI occurrences were found in 69.9% of the elderly people assessed. Of these, 25 were related to benzodiazepines. In the elderly individuals who use benzodiazepines, polypharmacy was associated with PDI (p<0.01; PR = 16.13; 95% CI, 4.67-55.55). PDI occurrence was high in the elderly people who use benzodiazepines, including interactions of highly significant clinical value. Conclusion In general, PDI is associated with polypharmacy, which demonstrates the need to rationalize drug use in the elderly population through continuous monitoring, seeking the simplest and safest possible therapeutic regimen.

Perfil farmacoterapêutico, clínico e sociodemográfico de adultos e idosos atendidos ambulatorialmente em um hospital psiquiátrico no Rio de Janeiro

“…14 The polypharmacy occurs frequently among elderly due to non-communicable chronic diseases, including degenerative diseases related to ageing, further increasing the vulnerability of this population to the medicines use. 6,15,16 The predominant prescription pattern for antipsychotics, anxiolytics and antidepressants observed in the general and geriatric outpatient clinics has also been identified in other studies carried out in the country. 7,17,18 The most prescribed antipsychotic at both clinics was risperidone, only antipsychotic standardized at the institution and widely used due to its lower potential for adverse reactions compared to typical antipsychotics.…”

“…The greater occurrence of more than one diagnostic hypothesis per patient in the geriatric outpatient clinic can be explained by the wider range of clinical and psychiatric comorbidities that affect the older adults population. 6,15 In addition to mood disorders, the geriatric outpatient clinic's most prevalent diagnoses were organic mental disorders (F00-F09), which include dementia in Alzheimer's disease (F00), degenerative diseases of the nervous system (G30-G32), represented by Alzheimer's disease (G30), and extrapyramidal diseases and movement disorders (G20-G26), the main one being Parkinson's disease (G20). Dementia is caused by various pathologies and lesions that affect the brain, the increased incidence of which accompanies ageing.…”

“…With the greater susceptibility of the elderly to the effects of medication, the risk of medication-related adverse events becomes high. 6 The analysis of the medications dispensing, especially medications subject to special control, helps to outline the needs of health services and identify factors associated with their consumption, contributing to the use qualification and health resources rationalization. 7 The aim of this study was to evaluate the dispensing profile of psychotropic medications to patients treated at a general ambulatory and a geriatric ambulatory at a public teaching psychiatric hospital, to examine the prevalence of mental and neurodegenerative disorders, and their sociodemographic aspects.…”

High prevalence of potential psychotropic drugs interactions among Brazilian dental patients

“…First, a significant proportion of studies about interactions are conducted with data from a single service; ours was a census. Second, the majority of published papers in the field focused on a sole therapeutic class, such as antidepressants or anxiolytics, while our study conducted a broad analysis, including all systemic drugs acting in the CNS (Alvim et al, 2021; Benard‐Laribiere et al, 2016; Candeloro et al, 2022; Delavenne et al, 2013; Zhou et al, 2020). Big data from pharmaceutical claims electronic systems are complex to handle, even so, it was possible to assess the temporal trend of drug prescriptions in order to establish PDDI.…”