Potentially inappropriate use of benzodiazepines and z-drugs in older population - analysis of association between inappropriate use and patient related factors


Introduction: Inappropriate benzodiazepines (BZD) and z-drugs use in older populations is associated with a variety of sociodemographic and health-related factors. Recent studies reported that inappropriate BZD and z-drugs use is associated with increased age, female gender, and severe negative psychological (e.g. depression) and somatic (e.g. chronic disease) factors. The current study explores the sociodemographic and health-related factors associated with inappropriate BZD and z-drugs use in older people. Methods: We conducted a cross-sectional survey among randomly selected patients of one health insurance (“AOK North-West”) with BZD and z-drugs prescriptions in the past 12 months. The sample was stratified by appropriateness to German prescription guidelines (yes vs. no) and age (50-65 vs. >65 years). To examine the association of selected sociodemographic and psychological variables (e.g. sex, employment status, quality of life, depression) with inappropriate use a binary logistic regression analysis was conducted. Results: In total, data of 340 patients were analyzed. The mean age was 72.1 (SD=14.5) years, and the most commonly used substances were zopiclon (38.1%), oxazepam (18.1%), and lorazepam (13.8%). The mean defined daily dose (DDD) was 0.73 (SD=0.47). Insomnia was the main reason for prescribing BZD and z-drugs. Inappropriate use of BZD and z-drugs is significantly associated with unemployment (OR=2.9, 95%-CI: 1.2-7.1) and general problematic medication use (OR=0.5, 95%-CI: 0.2-1.0).

Discussion: Unemployment status and problematic medication use have a significant association with potentially inappropriate prescription of BZD and z-drugs. Divergent patterns of prescription might harbor problematic patterns of BZD and z-drugs use. The causal connection between the identified factors and problematic BZD and z-drugs prescription is not released in this paper.

Conclusion: The employment status and possible evidence of inadequate drug use may be a warning signal for the prescriber of BZD and z-drugs.

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