Benzodiazepine prescriptions and falls in older men and women

被引:18
作者
Martinez-Cengotitabengoa, Monica [1 ,2 ]
Jose Diaz-Gutierrez, Maria [3 ]
Besga, Ariadna [1 ,4 ,5 ]
Bermudez-Ampudia, Cristina [1 ]
Lopez, Purificacion [1 ]
Rondon, Marta B. [6 ]
Stewart, Donna E. [7 ]
Perez, Patricia [1 ]
Gutierrez, Miguel [1 ,5 ]
Gonzalez-Pinto, Ana [1 ,5 ]
机构
[1] Hosp Univ Araba, BioAraba Res Inst, CIBERSAM, Dept Psiquiatria, Vitoria, Spain
[2] UNED, Ctr Asociado Vitoria, Vitoria, Spain
[3] Farm Ines Barrenechea, Getxo, Spain
[4] Hosp Univ Araba, Serv Urgencias, Vitoria, Spain
[5] Univ Basque Country, Vitoria, Spain
[6] Univ Cayetano Heredia, Dept Med, Unidad Psiquiatria & Salud Mental, Lima, Peru
[7] Univ Toronto, Univ Hlth Network, Ctr Mental Hlth, Toronto, ON, Canada
来源
REVISTA DE PSIQUIATRIA Y SALUD MENTAL | 2018年 / 11卷 / 01期
关键词
Benzodiazepines; Accidental falls; Aged; Gender; LONG-TERM USE; PSYCHOTROPIC MEDICATION; FUNCTIONAL STATUS; SLEEP DISORDERS; RISK; INSOMNIA; DRUGS; PHARMACOKINETICS; LORMETAZEPAM; METAANALYSIS;
D O I
10.1016/j.rpsm.2017.01.004
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Objective: Despite cautions by professional associations, benzodiazepines (BZD) and Z hypnotics (BZD/Z) are widely prescribed to older adults who are particularly susceptible to insomnia and anxiety, but who are also more sensitive to drugs adverse events. In this study, we assessed the prescription of BZD/Z drugs in a sample of older adults (>= 65) who presented for emergency care after a fall. Methods: We collected the type, number and dose of BZD/Z drugs prescribed and explored gender differences in the prescription. Results: BZD/Z drugs were prescribed to 43.6% of the sample (n = 654) and more frequently to women; 78.4% of prescriptions were for BZD/Z drugs with a short half-life. The majority of patients (83.5%) were prescribed only one type of BZD/Z, but 16.5% had been prescribed multiple BZD/Z drugs, with no gender difference. Doses higher than those recommended for older adults were prescribed to 58% of patients, being the doses significantly higher for men compared to women (70.0% vs 53.1%). Conclusions: Over 40% of older adults presenting for emergency care after a fall had previously been prescribed BZD/Z drugs. Some important gender differences in the prescription of BZD/Z drugs were seen, especially prescription above the recommended dose and of drugs with a long-half life. (C) 2017 SEP y SEPB. Published by Elsevier Espana, S.L.U. All rights reserved.
引用
收藏
页码:12 / 18
页数:7
相关论文
共 51 条
[1]  
AEMPS, CTR INF ONL MED AEMP
[2]   Effects on postural oscillation and memory functions of a single dose of zolpidem 5 mg, zopiclone 3.75 mg and lormetazepam 1 mg in elderly healthy subjects.: A randomized, cross-over, double-blind study versus placebo [J].
Allain, H ;
Bentué-Ferrer, D ;
Tarral, A ;
Gandon, JM .
EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY, 2003, 59 (03) :179-188
[3]  
[Anonymous], 2002, The Ashton Manual
[4]   Need for a realistic appraisal of benzodiazepines [J].
Balon, Richard ;
Fava, Giovanni A. ;
Rickels, Karl .
WORLD PSYCHIATRY, 2015, 14 (02) :243-244
[5]   Risk factors for falls of older citizens [J].
Boelens, C. ;
Hekman, E. E. G. ;
Verkerke, G. J. .
TECHNOLOGY AND HEALTH CARE, 2013, 21 (05) :521-533
[6]   The problems with the use of benzodiazepines in elderly patients [J].
Bourin, M. .
ENCEPHALE-REVUE DE PSYCHIATRIE CLINIQUE BIOLOGIQUE ET THERAPEUTIQUE, 2010, 36 (04) :340-347
[7]   Medication and Falls: Risk and Optimization [J].
Boyle, Nichola ;
Naganathan, Vasi ;
Cumming, Robert G. .
CLINICS IN GERIATRIC MEDICINE, 2010, 26 (04) :583-+
[8]   Prescribing for elderly people [J].
Burrage, Daniel R. ;
Lonsdale, Erin V. ;
Lonsdale, Dagan O. ;
Baker, Emma .
BRITISH JOURNAL OF HOSPITAL MEDICINE, 2014, 75 (08) :C119-C121
[9]  
Chouinard G, 2004, J CLIN PSYCHIAT, V65, P7
[10]  
Codony M, 2007, Actas Esp Psiquiatr, V35 Suppl 2, P29