Background: The use of benzodiazepines (BZDs) in older population is often accompanied by drug-related complications. Inappropriate BZD use significantly alters older adults’ clinical and functional status. This study compares the prevalence, prescribing patterns and factors associated with BZD use in community-dwelling older patients in 7 European countries. Methods: International, cross-sectional study was conducted in community-dwelling older adults (65 +) in the Czech Republic, Serbia, Estonia, Bulgaria, Croatia, Turkey, and Spain between Feb2019 and Mar2020. Structured and standardized questionnaire based on interRAI assessment scales was applied. Logistic regression was used to evaluate factors associated with BZD use. Results: Out of 2,865 older patients (mean age 73.2 years ± 6.8, 61.2% women) 14.9% were BZD users. The highest prevalence of BZD use was identified in Croatia (35.5%), Spain (33.5%) and Serbia (31.3%). The most frequently prescribed BZDs were diazepam (27.9% of 42...6 BZD users), alprazolam (23.7%), bromazepam (22.8%) and lorazepam (16.7%). Independent factors associated with BZD use were female gender (OR 1.58, 95%CI 1.19–2.10), hyperpolypharmacy (OR 1.97, 95%CI 1.22–3.16), anxiety (OR 4.26, 95%CI 2.86–6.38), sleeping problems (OR 4.47, 95%CI 3.38–5.92), depression (OR 1.95, 95%CI 1.29–2.95), repetitive anxious complaints (OR 1.77, 95%CI 1.29–2.42), problems with syncope (OR 1.78, 95%CI 1.03–3.06), and loss of appetite (OR 0.60, 95%CI 0.38–0.94). In comparison to Croatia, residing in other countries was associated with lower odds of BZD use (ORs varied from 0.49 (95%CI 0.32–0.75) in Spain to 0.01 (95%CI 0.00–0.03) in Turkey), excluding Serbia (OR 1.11, 95%CI 0.79–1.56). Conclusions: Despite well-known negative effects, BZDs are still frequently prescribed in older outpatient population in European countries. Principles of safer geriatric prescribing and effective deprescribing strategies should be individually applied in older BZD users.
Keywords:
Europe / Benzodiazepines / Community-dwelling older adults / Geriatric dosing / Geriatric length of therapy
Source:
BMC Geriatrics, 2024, 24, 1
Publisher:
BioMed Central Ltd
Funding / projects:
The European Union (EU) funded project InoMed, reg. No: CZ.02.1.01/0.0/0.0/18_069/0010 046 (2019–2022)
The European Union’s Horizon 2020
Innovation programme under the Marie Skłodowska‑Curie grant agreement No. 764632 (EuroAgeism H2020 ESR7 project)
The European Union’s Horizon 2020 research and innovation programme under grant agreement No 965341
The I‑CARE4 OLD Horizon 2020 project.
The EuroAgeism H2020 ESR7 project
The grant agreement of the Marie Skłodowska‑Curie Foundation number MSCF‑ITN‑764632
The research group “Aging, polypharmacotherapy and changes in therapeutic value of drugs in the aged” (chair: Assoc. Prof. Daniela Fialova, PharmD., Ph.D.)
The scientific program Cooperatio KSKF1 of the Faculty of Pharmacy, Charles Uni‑ versity in Hradec Kralove
The project START / MED / 093 EN.02.2.69 / 0.0 / 0.0 / 19_073 / 0016935 and SVV program 260 665, and the project NETPHARM (New Technologies for Translational Research in Pharmaceutical Sciences
TY - JOUR
AU - Lukačišinová, Anna
AU - Reissigová, Jindra
AU - Ortner-Hadžiabdić, Maja
AU - Brkić, Jovana
AU - Okuyan, Betul
AU - Volmer, Daisy
AU - Tadić, Ivana
AU - Modamio, Pilar
AU - Mariño, Eduardo
AU - Tachkov, Konstantine
AU - Liperotti, Rosa
AU - Onder, Graziano
AU - Finne-Soveri, Harriet
AU - van Hout, Hein
AU - Howard, Elizabeth P.
AU - Fialová, Daniela
PY - 2024
UR - https://farfar.pharmacy.bg.ac.rs/handle/123456789/5563
AB - Background: The use of benzodiazepines (BZDs) in older population is often accompanied by drug-related complications. Inappropriate BZD use significantly alters older adults’ clinical and functional status. This study compares the prevalence, prescribing patterns and factors associated with BZD use in community-dwelling older patients in 7 European countries. Methods: International, cross-sectional study was conducted in community-dwelling older adults (65 +) in the Czech Republic, Serbia, Estonia, Bulgaria, Croatia, Turkey, and Spain between Feb2019 and Mar2020. Structured and standardized questionnaire based on interRAI assessment scales was applied. Logistic regression was used to evaluate factors associated with BZD use. Results: Out of 2,865 older patients (mean age 73.2 years ± 6.8, 61.2% women) 14.9% were BZD users. The highest prevalence of BZD use was identified in Croatia (35.5%), Spain (33.5%) and Serbia (31.3%). The most frequently prescribed BZDs were diazepam (27.9% of 426 BZD users), alprazolam (23.7%), bromazepam (22.8%) and lorazepam (16.7%). Independent factors associated with BZD use were female gender (OR 1.58, 95%CI 1.19–2.10), hyperpolypharmacy (OR 1.97, 95%CI 1.22–3.16), anxiety (OR 4.26, 95%CI 2.86–6.38), sleeping problems (OR 4.47, 95%CI 3.38–5.92), depression (OR 1.95, 95%CI 1.29–2.95), repetitive anxious complaints (OR 1.77, 95%CI 1.29–2.42), problems with syncope (OR 1.78, 95%CI 1.03–3.06), and loss of appetite (OR 0.60, 95%CI 0.38–0.94). In comparison to Croatia, residing in other countries was associated with lower odds of BZD use (ORs varied from 0.49 (95%CI 0.32–0.75) in Spain to 0.01 (95%CI 0.00–0.03) in Turkey), excluding Serbia (OR 1.11, 95%CI 0.79–1.56). Conclusions: Despite well-known negative effects, BZDs are still frequently prescribed in older outpatient population in European countries. Principles of safer geriatric prescribing and effective deprescribing strategies should be individually applied in older BZD users.
PB - BioMed Central Ltd
T2 - BMC Geriatrics
T1 - Prevalence, country-specific prescribing patterns and determinants of benzodiazepine use in community-residing older adults in 7 European countries
VL - 24
IS - 1
DO - 10.1186/s12877-024-04742-7
ER -
@article{
author = "Lukačišinová, Anna and Reissigová, Jindra and Ortner-Hadžiabdić, Maja and Brkić, Jovana and Okuyan, Betul and Volmer, Daisy and Tadić, Ivana and Modamio, Pilar and Mariño, Eduardo and Tachkov, Konstantine and Liperotti, Rosa and Onder, Graziano and Finne-Soveri, Harriet and van Hout, Hein and Howard, Elizabeth P. and Fialová, Daniela",
year = "2024",
abstract = "Background: The use of benzodiazepines (BZDs) in older population is often accompanied by drug-related complications. Inappropriate BZD use significantly alters older adults’ clinical and functional status. This study compares the prevalence, prescribing patterns and factors associated with BZD use in community-dwelling older patients in 7 European countries. Methods: International, cross-sectional study was conducted in community-dwelling older adults (65 +) in the Czech Republic, Serbia, Estonia, Bulgaria, Croatia, Turkey, and Spain between Feb2019 and Mar2020. Structured and standardized questionnaire based on interRAI assessment scales was applied. Logistic regression was used to evaluate factors associated with BZD use. Results: Out of 2,865 older patients (mean age 73.2 years ± 6.8, 61.2% women) 14.9% were BZD users. The highest prevalence of BZD use was identified in Croatia (35.5%), Spain (33.5%) and Serbia (31.3%). The most frequently prescribed BZDs were diazepam (27.9% of 426 BZD users), alprazolam (23.7%), bromazepam (22.8%) and lorazepam (16.7%). Independent factors associated with BZD use were female gender (OR 1.58, 95%CI 1.19–2.10), hyperpolypharmacy (OR 1.97, 95%CI 1.22–3.16), anxiety (OR 4.26, 95%CI 2.86–6.38), sleeping problems (OR 4.47, 95%CI 3.38–5.92), depression (OR 1.95, 95%CI 1.29–2.95), repetitive anxious complaints (OR 1.77, 95%CI 1.29–2.42), problems with syncope (OR 1.78, 95%CI 1.03–3.06), and loss of appetite (OR 0.60, 95%CI 0.38–0.94). In comparison to Croatia, residing in other countries was associated with lower odds of BZD use (ORs varied from 0.49 (95%CI 0.32–0.75) in Spain to 0.01 (95%CI 0.00–0.03) in Turkey), excluding Serbia (OR 1.11, 95%CI 0.79–1.56). Conclusions: Despite well-known negative effects, BZDs are still frequently prescribed in older outpatient population in European countries. Principles of safer geriatric prescribing and effective deprescribing strategies should be individually applied in older BZD users.",
publisher = "BioMed Central Ltd",
journal = "BMC Geriatrics",
title = "Prevalence, country-specific prescribing patterns and determinants of benzodiazepine use in community-residing older adults in 7 European countries",
volume = "24",
number = "1",
doi = "10.1186/s12877-024-04742-7"
}
Lukačišinová, A., Reissigová, J., Ortner-Hadžiabdić, M., Brkić, J., Okuyan, B., Volmer, D., Tadić, I., Modamio, P., Mariño, E., Tachkov, K., Liperotti, R., Onder, G., Finne-Soveri, H., van Hout, H., Howard, E. P.,& Fialová, D.. (2024). Prevalence, country-specific prescribing patterns and determinants of benzodiazepine use in community-residing older adults in 7 European countries. in BMC Geriatrics
BioMed Central Ltd., 24(1).
https://doi.org/10.1186/s12877-024-04742-7
Lukačišinová A, Reissigová J, Ortner-Hadžiabdić M, Brkić J, Okuyan B, Volmer D, Tadić I, Modamio P, Mariño E, Tachkov K, Liperotti R, Onder G, Finne-Soveri H, van Hout H, Howard EP, Fialová D. Prevalence, country-specific prescribing patterns and determinants of benzodiazepine use in community-residing older adults in 7 European countries. in BMC Geriatrics. 2024;24(1).
doi:10.1186/s12877-024-04742-7 .
Lukačišinová, Anna, Reissigová, Jindra, Ortner-Hadžiabdić, Maja, Brkić, Jovana, Okuyan, Betul, Volmer, Daisy, Tadić, Ivana, Modamio, Pilar, Mariño, Eduardo, Tachkov, Konstantine, Liperotti, Rosa, Onder, Graziano, Finne-Soveri, Harriet, van Hout, Hein, Howard, Elizabeth P., Fialová, Daniela, "Prevalence, country-specific prescribing patterns and determinants of benzodiazepine use in community-residing older adults in 7 European countries" in BMC Geriatrics, 24, no. 1 (2024),
https://doi.org/10.1186/s12877-024-04742-7 . .
