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Correlates of Potentially Inappropriate Prescriptions of Benzodiazepines among Older Adults: Results from the ESA Study*

Published online by Cambridge University Press:  17 July 2012

Michel Préville*
Affiliation:
Université de Sherbrooke Charles LeMoyne Hospital Research Center
Cindy Bossé
Affiliation:
Université de Sherbrooke
Helen-Maria Vasiliadis
Affiliation:
Université de Sherbrooke Charles LeMoyne Hospital Research Center
Philippe Voyer
Affiliation:
Université Laval
Claudine Laurier
Affiliation:
Université de Montréal
Djamal Berbiche
Affiliation:
Charles LeMoyne Hospital Research Center
Guiilhème Pérodeau
Affiliation:
Charles LeMoyne Hospital Research Center Université du Québec en Outaouais
Sébastien Grenier
Affiliation:
Charles LeMoyne Hospital Research Center
Sarah-Gabrielle Béland
Affiliation:
Université de Montréal
Pierre-Alexandre Dionne
Affiliation:
Université de Sherbrooke
Lia Gentil
Affiliation:
Université de Sherbrooke
Yola Moride
Affiliation:
Université de Montréal Research Centre of the Centre Hospitalier de l’Université de Montréal (CRCHUM)
*
Correspondence and requests for offprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: Michel Préville, Ph.D. Research Centre, Hôpital Charles LeMoyne 3120, boul. Taschereau Greenfield Park, QC J4V 2H1 michel.preville@usherbrooke.ca)

Abstract

ESA study data were paired with Quebec medical and pharmaceutical services records to document potentially inappropriate benzodiazepines (Bzs) prescriptions among community-dwelling adults aged 65 and older. Results indicate that 32 per cent of respondents took a mean daily dose of 6.1 mg of equivalent diazepam for, on average, 205 days per year. Almost half (48%) of Bzs users received a potentially inappropriate benzodiazepine prescription at least once during the year preceding the survey. About 23 per cent received at least one concomitant prescription of a Bz and another drug that could result in serious interaction. In addition, individuals aged 75 and older were more likely to receive Bzs for a longer period of time than those aged 65–74. Number of pharmacies used was associated with inappropriate Bzs prescriptions. Our results argue in favour of a more integrated health services system, including a regular review of older adults’ drug regimens.

Résumé

Les données de l’étude ESA ont été appariées aux données d’utilisation des services médicaux et pharmaceutiques de la Régie d’assurance maladie du Québec pour documenter la prescription potentiellement non appropriée de benzodiazépines chez les personnes âgées. Nos résultats indiquent que 32% des répondants ont pris une dose journalière moyenne de 6.1 mg de l’équivalent diazépam pour une durée moyenne de 205 jours par année. Nos résultats indiquent aussi que presque la moitié, 48% des utilisateurs de benzodiazépines, ont reçu au moins une prescription de benzodiazépine potentiellement non appropriée pendant les 12 mois qui précédaient l’étude. Près de 23% des consommateurs ont reçu au moins une prescription concomitante de Bzs et d’un autre médicament pouvant résulter en une interaction sérieuse. De plus, les personnes âgées de 75 ans et plus avaient plus de chances de recevoir une Bz pour une longue période de temps que les personnes âgées de 65-74 ans. Cette étude a montré que la durée d’utilisation des benzodiazépines augmentait avec le nombre de prescripteurs et avec le nombre de pharmacies consultées pendant l’année. Le nombre de pharmacies utilisées a aussi été associé avec la présence d’une ordonnance non appropriée de benzodiazépines pendant la même année. Nos résultats plaident en faveur d’un système de santé plus intégré, incluant une révision régulière des médicaments pris par les personnes âgées.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2012

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Footnotes

*

This study was supported by the Canadian Institutes of Health Research (200403MOP) and by the Fonds de la recherche en santé du Québec (FRSQ-Conseil du medicament: 051719). The authors thank members of the Scientific Committee of the ESA Study (Étude sur la Santé des Aïnés) for the significant scientific advice they provided, and Bernadette Wilson, who provided editing comments.

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