Prevalence, country-specific prescribing patterns and determinants of benzodiazepine use in community-residing older adults in 7 European countries

• Published in: BMC geriatrics Vol. 24; no. 1; p. 240
• Main Authors: Lukačišinová, Anna, Reissigová, Jindra, Ortner-Hadžiabdić, Maja, Brkic, Jovana, Okuyan, Betul, Volmer, Daisy, Tadić, Ivana, Modamio, Pilar, Mariño, Eduardo L, Tachkov, Konstantine, Liperotti, Rosa, Onder, Graziano, Finne-Soveri, Harriet, van Hout, Hein, Howard, Elizabeth P, Fialová, Daniela
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 07-03-2024; BioMed Central; BMC
• Subjects: Aged; Aged patients; Alprazolam; Antianxiety agents; Anxiety; Anxiety Disorders; Appetite loss; Benzodiazepines; Benzodiazepines - adverse effects; Community-dwelling older adults; Cross-Sectional Studies; Data collection; Dementia; Diazepam; Dosage and administration; Drug dosages; Drug therapy; Emotions; Europe; Europe - epidemiology; Female; Geriatric dosing; Geriatric length of therapy; Geriatrics; Humans; Hypnotics; Lorazepam; Male; Mental depression; Older people; Patients; Population; Prescription writing; Prevalence; Questionnaires; R&D; Regression analysis; Research & development; Sedatives; Sleep disorders; Surveys; Syncope; Europe; Czech Republic; Bulgaria; Serbia; Croatia; Spain; Estonia; Geriatric dosing; Community-dwelling older adults; Geriatric length of therapy; Europe; Benzodiazepines
• ISSN: 1471-2318; 1471-2318
• DOI: 10.1186/s12877-024-04742-7

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.
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.
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).
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.