Inappropriate prescription of benzodiazepines in acutely hospitalized older patients

REPOSI collaborators, C. Franchi, R. Rossio, I. Ardoino, P. M. Mannucci, A. Nobili

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Benzodiazepines (BDZs) are widely prescribed in older people. The aims of the study are to assess the prevalence of inappropriate prescription of BZDs and the associated factors in acutely hospitalized older patients. Patients aged 65 years or more hospitalized from 2010 to 2017 in more than 100 Italian internal medicine and geriatric wards in the frame of the REPOSI register were included if prescribed with BDZs at hospital admission or discharge. Appropriateness of prescription was assessed according to the 2015 Beers criteria and their modified French and German versions. Among 4681 patients discharged from hospital, 15% (N = 710) were discharged with BDZs, and 62% of them (N = 441, 95% CI: 58.5%–65.6%) were inappropriately prescribed, being prescribed with BDZ to be always avoided in the elderly (45%), at higher doses than recommended (31%) or with no appropriate clinical conditions (19%). From admission to discharge the prevalence of inappropriate BDZ prescription decreased by 4%, but 62% of patients inappropriately prescribed at admission were still inappropriately prescribed at discharge. Among the 179 patients first prescribed at the time of discharge, half were inappropriately prescribed. Being female (OR 1.32, 95%CI 0.95–1.85), enrolled in REPOSI during the years 2016 and 2017 (OR 1.94, 95%CI 1.10–3.39; OR 1.57, 95%CI 0.95–2.58) and living in nursing homes (OR 2.04, 95%CI 0.95–4.37) were associated with an increased risk to be inappropriately prescribed. This study shows a high prevalence of inappropriate use of BDZ in acutely hospitalized older patients both at hospital admission and discharge.

Original languageEnglish
Pages (from-to)871-879
JournalEuropean Neuropsychopharmacology
Volume29
Issue number7
DOIs
Publication statusPublished - Jan 1 2019

Fingerprint

Inappropriate Prescribing
Benzodiazepines
Internal Medicine
Nursing Homes
Geriatrics
Prescriptions

Keywords

  • Appropriateness of prescription
  • Benzodiazepine
  • Hypnotics
  • Internal medicine and geriatric wards
  • Older people
  • REPOSI register

ASJC Scopus subject areas

  • Pharmacology
  • Neurology
  • Clinical Neurology
  • Psychiatry and Mental health
  • Biological Psychiatry
  • Pharmacology (medical)

Cite this

Inappropriate prescription of benzodiazepines in acutely hospitalized older patients. / REPOSI collaborators ; Franchi, C.; Rossio, R.; Ardoino, I.; Mannucci, P. M.; Nobili, A.

In: European Neuropsychopharmacology, Vol. 29, No. 7, 01.01.2019, p. 871-879.

Research output: Contribution to journalArticle

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abstract = "Benzodiazepines (BDZs) are widely prescribed in older people. The aims of the study are to assess the prevalence of inappropriate prescription of BZDs and the associated factors in acutely hospitalized older patients. Patients aged 65 years or more hospitalized from 2010 to 2017 in more than 100 Italian internal medicine and geriatric wards in the frame of the REPOSI register were included if prescribed with BDZs at hospital admission or discharge. Appropriateness of prescription was assessed according to the 2015 Beers criteria and their modified French and German versions. Among 4681 patients discharged from hospital, 15{\%} (N = 710) were discharged with BDZs, and 62{\%} of them (N = 441, 95{\%} CI: 58.5{\%}–65.6{\%}) were inappropriately prescribed, being prescribed with BDZ to be always avoided in the elderly (45{\%}), at higher doses than recommended (31{\%}) or with no appropriate clinical conditions (19{\%}). From admission to discharge the prevalence of inappropriate BDZ prescription decreased by 4{\%}, but 62{\%} of patients inappropriately prescribed at admission were still inappropriately prescribed at discharge. Among the 179 patients first prescribed at the time of discharge, half were inappropriately prescribed. Being female (OR 1.32, 95{\%}CI 0.95–1.85), enrolled in REPOSI during the years 2016 and 2017 (OR 1.94, 95{\%}CI 1.10–3.39; OR 1.57, 95{\%}CI 0.95–2.58) and living in nursing homes (OR 2.04, 95{\%}CI 0.95–4.37) were associated with an increased risk to be inappropriately prescribed. This study shows a high prevalence of inappropriate use of BDZ in acutely hospitalized older patients both at hospital admission and discharge.",
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