Seniors Not Taking Benzos With Care

Benzodiazepine prescriptions that were poorly tracked resulted in hospitalizations

(RxWiki News) Keeping track of when to take which prescriptions can be very confusing. But failing to do so could end in a trip to the hospital. And seniors on psychoactive medications might need to take extra care.

A recent study surveyed a group of seniors about which prescription medications they had taken in the past year and if they made any visits to a doctor or hospital. 

The researchers found that many patients were prescribed benzodiazepines that could interact dangerously with their other prescriptions or they were taking doses that were too high.

The authors recommended electronic prescription tracking for senior patients.

"Tell each of your doctors about all of your meds."

Pierre-Alexandre Dionne, MSc, from the Department of Community Health Sciences at the University of Sherbrooke in Quebec, Canada, led an investigation into the costs and medication interactions associated with a certain class of prescriptions given to senior patients. 

For the study, 2,320 men and women aged 65 years and older were surveyed in 2006 about their prescription medications over the previous year.

The results of the study showed that 32 percent of those surveyed were prescribed benzodiazepines, a psychoactive medication.

The medication class of benzodiazepine includes, but is not limited to: alprazolam (Xanax), diazepam (Valium), clonazepam (Klonopin) and lorazepam (Ativan).

“Benzodiazepines, the most prescribed [medications] among the sedative, hypnotic, and anxiolytic (anti-anxiety) agents, are associated with potential drug abuse and significant rebound effect related to withdrawal,” according to the authors.

The researchers found that among the patients with a prescription for a benzodiazepine, 44 percent were given “inappropriate” prescriptions.

Of those with inappropriate prescriptions, 15 percent were prescribed another medication that could interact dangerously with a benzodiazepine, 22 percent were prescribed too high of a dose and 7 percent had both problems.

Among benzodiazepine users, 9 percent had been to the emergency room at least once, 20 percent had been hospitalized at least once and 68 percent had eight or more outpatient visits, all in the previous year.

The authors said senior patients that take benzodiazepines might be at an increased risk for falling, fracturing bones and accidents due to the sedative effect of the medication.

The average healthcare bill for a person with an inappropriate benzodiazepine prescription was $3,076 higher per year than for a person who was not taking benzodiazepines.

The authors recommended using updated electronic prescription medication monitoring systems for senior patients to help track potential medication interactions and prevent inappropriate dosages.

"Many physicians struggle to determine the medications being taken by their patients. Given the rapid pace with which medical evidence develops, it can also be difficult for them to make decisions consistent with the latest guidelines. As we move towards greater use of Electronic Health Records, paired with Clinical Decision Support Systems, we will hopefully reduce the frequency with which errors hampering the cost and quality of care are made. This study helps demonstrate how costly such errors can be," said Adam Powell, PhD, an expert in healthcare economics. Dr. Powell had no part in this study. 

This study was published in April in Psychiatric Services.

The Canadian Institutes of Health Research, the Quebec Health Research Fund supported funding for this project. Mr. Dionne did an internship with Pfizer Canada, but no other potential conflicts of interest were reported.

Review Date: 
April 1, 2013