Prescribing Rate of Benzodiazepines and Factors Associated with the Decision of General Practitioners to Prescribe Benzodiazepine in Elderly Patients, Rajavithi Hospital
Article Sidebar
Main Article Content
Abstract
Introduction and Objectives: Physicians are recommended to avoid prescribing benzodiazepine for older patients due to the adverse effects including increased risk of dementia, falls, and trauma, which may cause hospitalization or in severe cases, mortality. Thus, the author aimed to investigate the prescription rate and factors associated with the prescribing decisions of benzodiazepine in older patients by general practitioners in a tertiary hospital.
Methods: A cross-sectional study was conducted from January to June 2020. The questionnaire consisted of personal characteristics, the prescribing decision of benzodiazepines in older patients with five medical conditions, the experience of unnecessary prescribing of benzodiazepine, and reference of prescriptions. Also, descriptive statistics: Chi-square, and Fisher’s exact test were applied in this study.
Results: Ninety-two participants with an average age of 29 ± 5.5 years were primarily in residency training programs (87%) with average working hours of 40 hours per week. It was found from the questionnaire that the benzodiazepine prescribing decisions of general practitioners was 66.3% for older patients with anxiety. One factor significantly different between the prescribing and non-prescribing groups in older patients with hypertension was the number of working hours per week (p = 0.01).
Conclusions: The rate of the prescribing decision of benzodiazepine by general practitioners to elderly patients with anxiety is quite high at 66.3%. Hence, simplified prescribing guidelines should be provided for general practitioners. Also, it was found that high working hours (per week) was the factor associated with the prescribing decision of benzodiazepine in older patients with hypertension. Further study should be conducted regarding this finding.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The content and information in articles published in the PCFM journal are solely the opinions and responsibilities of the authors. The journal's editorial board does not necessarily agree with or share any responsibility for them.
All articles, information, content, images, etc., published in the PCFM journal are the copyright of the PCFM journal. If any individual or organization wishes to reproduce, distribute, or use any part or the entirety of the content, they must obtain written permission from the PCFM journal beforehand.
References
หล่อตระกูล ม. คู่มือการดูแลผู้มีปัญหาสุขภาพจิตและจิตเวชสําหรับแพทย์: กรมสุขภาพจิต; 2001.
Ashton H. Guidelines for the rational use of benzodiazepines. When and what to use. Drugs. 1994;48(1):25-40.
Panel BtAGSBCUE. American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults. Journal of the American Geriatrics Society. 2019;67(4):674-94.
O'Mahony D, O'Sullivan D, Byrne S, O'Connor MN, Ryan C, Gallagher P. STOPP/START criteria for potentially inappropriate prescribing in older people: version 2. Age Ageing. 2015;44(2):213-8.
Airagnes G, Pelissolo A, Lavallée M, Flament M, Limosin F. Benzodiazepine Misuse in the Elderly: Risk Factors, Consequences, and Management. Curr Psychiatry Rep. 2016;18(10):89.
Brett J, Murnion B. Management of benzodiazepine misuse and dependence. Aust Prescr. 2015;38(5):152-5.
Robinson ADT. Drag Misuse and Dependence. Guidelines on Clinical Management. Report of a Medical Working Group. London: HMSO. 1991. 58 pp. British Journal of Psychiatry. 1993;162(4):585-.
Creupelandt H, Anthierens S, Habraken H, Sirdifield C, Siriwardena AN, Christiaens T. A tailored e-learning gives long-term changes in determinants of GPs’ benzodiazepines prescribing: a pretest-posttest study with self-report assessments. Scandinavian Journal of Primary Health Care. 2019;37(4):418-25.
Sirdifield C, Anthierens S, Creupelandt H, Chipchase SY, Christiaens T, Siriwardena AN. General practitioners' experiences and perceptions of benzodiazepine prescribing: systematic review and meta-synthesis. BMC family practice. 2013;14:191-.
Vicens C, Leiva A, Bejarano F, Sempere- Verdú E, Rodríguez-Rincón RM, Fiol F, et al. Evaluation of a multicomponent intervention consisting of education and feedback to reduce benzodiazepine prescriptions by general practitioners: The BENZORED hybrid type 1 cluster randomized controlled trial. PLoS Medicine. 2022;19(5).
Luta X, Bagnoud C, Lambiris M, Decollogny A, Eggli Y, Le Pogam MA, et al. Patterns of benzodiazepine prescription among older adults in Switzerland: A cross-sectional analysis of claims data. BMJ Open. 2020;10(1).
Maust DT, Blow FC, Wiechers IR, Kales HC, Marcus SC. National Trends in Antidepressant, Benzodiazepine, and Other Sedative-Hypnotic Treatment of Older Adults in Psychiatric and Primary Care. J Clin Psychiatry. 2017;78(4):e363-e71.
Champion C, Kameg BN. Best practices in benzodiazepine prescribing and management in primary care. The Nurse Practitioner. 2021;46(3).
Agarwal SD, Landon BE. Patterns in Outpatient Benzodiazepine Prescribing in the United States. JAMA Network Open. 2019;2(1):e187399-e.
Tu K, Mamdani MM, Hux JE, Tu J-b. Progressive Trends in the Prevalence of Benzodiazepine Prescribing in Older People in Ontario, Canada. Journal of the American Geriatrics Society. 2001;49(10):1341-5.
Prueksaritanond S TS, Pumkompol T, Sukying C. . Psychotropic Drug Prescribing in the Family Medicine Out-Patient Clinic, Ramathibodi Hospital. Journal of the MEDICAL ASSOCIATION OF THAILAND. 2009;92(2):266-72.
WD. W. Biostatistics: A foundation of analysis in the health sciences. New York: John Wiley and Sons; 1995.
Bjørner T, Lærum E. Factors associated with high prescribing of benzodiazepines and minor opiates. Scandinavian Journal of Primary Health Care. 2003;21(2):115-20.
Srisurapanont M, Garner P, Critchley J, Wongpakaran N. Benzodiazepine prescribing behaviour and attitudes: a survey among general practitioners practicing in northern Thailand. BMC family practice. 2005;6:27-.
Fernández Alvarez T, Gómez Castro MJ, Baides Morente C, Martínez Fernández J. [Factors that affect the prescription of benzodiazepines and actions to improve their use: a Delphi study of primary care doctors]. Aten Primaria. 2002;30(5):297-303.
