Background Benzodiazepines are among the most commonly prescribed drugs in older people despite evidence of increased sensitivity and slower metabolism in this group of patients. Hospital discharge represents a critical moment of care transition where inappropriate prescription of benzodiazepines might be detected and potentially avoided or corrected. Hospital pharmacists are ideally placed to play an active role in this.
Purpose The objective of our study was to determine the prevalence of the potentially inappropriate prescriptions (PIP) of benzodiazepines among comorbid older patients at hospital discharge.
Material and methods Cross sectional study performed among patients aged 65 years or more, and hospitalised and discharged between July 2011 and June 2012 from a university specialty hospital. The set of data included in the clinical discharge reports were collected by a trained pharmacist. Only patients with a calculated Charlson Comorbidity Index higher than 2 were included in the study. PIPs were identified by applying the Beers 2012 criteria. We estimated the prevalence of PIPs and its 95% confidence interval. The statistical package Stata, v.10.0 (Stata Corp LP) was used for data analysis.
Results 624 patients were included in our study. Median age was 78 years and 32.5% of the sample suffered from high comorbidity (Charlson Comorbidity Index ≥4). The number of drugs prescribed had a median value of 8 (range 1–21). Benzodiazepines were prescribed to 165 patients (26.4%) and were potentially inappropriate according to Beers criteria in 11 cases (6.67% of the prescriptions containing a benzodiazepine) for the treatment of insomnia, agitation or delirium.
Conclusion We found that 6.67% of the benzodiazepines were inappropriately prescribed in comorbid older patients at hospital discharge. Hospital pharmacists should be involved in the medication review and in the reduction in PIPs, including benzodiazepines. Further research about prescription appropriateness of benzodiazepines among older people in different settings would allow better understanding of the extent of the problem and would contribute to the potential prevention of PIPs.
References and/or Acknowledgements
American Geriatrics Society 2012, Beers Criteria Update Expert Panel. American Geriatrics Society updated Beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc 2012;60:616-31
References and/or AcknowledgementsNo conflict of interest.
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