Sp.19 Benzodiazepines And Inadequate Medical Prescription

Author(s): 
S. Lumbreras Garuz1, R. Melió García1, C. Manzano Guillén2, L. Pifarré Portella2, N. Moreno Millán3
1 ABS Chafarinas, Family Doctor, Barcelona, Spain
2 ABS Chafarinas, 3rd year resident of MFiC, Barcelona, Spain
3 ABS Chafarinas, Preventive Health Technician, Barcelona, Spain
Text: 
Objectives.
To determine the existence of PMI (inadequate medical prescription) in benzodiazepine users. To describe risk factors of PMI. Design. Cross-over, descriptive study. Setting. Primary care centre, Spain. Subjects. 300 patients older than 65 years assigned to the centre, randomly chosen.
Methods.
Similar studies have found around 20% of PMI. To obtained the prevalence of PMI in our patients we collected the clinical record information and applied the 1997’s Beers Criteria. Descriptive and bivariate analyses were performed.
Results.
In our centre the prevalence of chronic benzodiazepine consumption was 15.7% according to the data from authorized chronic medication information register. The average of age of the sample was 76 ± 6.7 years old. 81.3% were women. The average of chronic diseases was 4.2 ± 1.6 and of consumed daily drugs was 6.5 ± 3.11. The most prescribed benzodiazepines were lorazepam (38.2%), diazepam (19.1%) and alprazolam (10.1%). 19.1% went to the psychiatry. Prescription related diagnoses were anxiety (16.3%) and depression and mixed anxiety-depression (13.9% both). 36.7% had no related diagnoses. There was PMI in 28.3%, mostly because of diazepam inadequate use (69.0%). Statistically significant differences were only observed between PMI and the greater number of daily consumed drugs (p = 0.038)
Conclusions.
Almost 3 of each 10 benzodiazepines prescriptions would be inadequate according to the Beers criteria. More than a third of chronic benzodiazepine users had no prescription related diagnoses. Should we think in medicalisation? We’re not able to describe a risk profile of PMI in our sample.
Literature: 
SP.19 BENZODIAZEPINES AND INADEQUATE MEDICAL PRESCRIPTION