The factors associated with inappropriate prescription patterns of benzodiazepines and related drugs among patients with dementia

• Published in: Psychogeriatrics Vol. 20; no. 4; pp. 447 - 457
• Main Authors: Tien, Shin‐Chiao, Chan, Hung‐Yu, Hsu, Chun‐Chi
• Format: Journal Article
• Language: English
• Published: Melbourne John Wiley & Sons Australia, Ltd 01.07.2020; Blackwell Publishing Ltd
• Subjects: Benzodiazepines; Benzodiazepines - therapeutic use; Dementia; Dementia - drug therapy; Dementia disorders; Drug dosages; high dose; Humans; Inappropriate Prescribing; long‐term treatment; Medical records; Patients; Pharmaceutical Preparations; Polypharmacy; Retrospective Studies; long-term treatment; dementia; benzodiazepines; polypharmacy; high dose
• ISSN: 1346-3500; 1479-8301
• DOI: 10.1111/psyg.12527

Background It has been emphasised that benzodiazepines and related drugs (BZDRs) should be used cautiously in people with dementia. The aim of this study was to identify factors associated with inappropriate prescription patterns of BZDRs including polypharmacy, long‐term treatment and high doses among patients with dementia taking BZDRs. Methods This was a retrospective chart review study of patients with dementia who were treated at the study hospital. The date that the patient was issued a catastrophic illness certificate from the National Health Insurance Administration was used as the index date. Medical records of the 2‐year period after the index date were reviewed. Results A total of 308 patients with dementia were included in this study. Among them, 151 (49.0%) received at least one prescription of BZDRs. After adjusting for covariates, psychiatric comorbidities (adjusted odds ratio (aOR) = 4.74, 95% CI = 1.75–12.81), history of past suicidal behaviour (aOR = 4.25, 95% CI = 1.40–12.88) and long‐term treatment with BZDRs (aOR = 3.38, 95% CI = 1.11–10.27) were associated with polypharmacy of BZDRs. Age (aOR = 1.05, 95% CI = 1.0–1.11) and polypharmacy (aOR = 3.57, 95% CI = 1.23–10.32) were associated with long‐term treatment. Living with family (aOR = 3.33, 95% CI = 1.32–9.79) and fewer psychiatric admissions to the study hospital (aOR = 0.56, 95% CI = 0.36–0.86) were associated with treatment with high doses of BZDRs. Conclusions Treatment with BZDRs is prevalent in patients with dementia. Inappropriate prescription patterns of BZDRs are not uncommon in these patients and may be interlinked.