Elderly Health

Benzodiazepine overuse in older adults (ages 65 years or older)

Individuals who have overused benzodiazepine (numerator), among Individuals aged 65 years or older (denominator)

Rational:

Benzodiazepines are sleep-inducing and anti-anxiety drugs. Studies have shown that using benzodiazepines in the elderly increases the risk of accidents, falls and fractures. In addition, their use for extended periods of time may lead to problems associated with discontinuation and withdrawal symptoms [1]. Hence, several guidelines and expert consensus statements recommend avoiding benzodiazepine use for longer periods, especially in older populations [2]. Furthermore, Elderly persons are particularly sensitive to the side effects of benzodiazepines, due to the increased sensitivity of the nervous system, and a slower metabolism [3]. Therefore, guidelines recommend that the use of long-acting benzodiazepines by older adults be avoided [4].

Numerator:

Individuals in the denominator who have purchased at least 365 DDD of benzodiazepines or Z-drugs during the measurement year

Denominator

Individuals aged 65 years or older

Notes:

None

Notes:

[1] Olfson M, King M, Schoenbaum M. Benzodiazepine Use in the United States. JAMA Psychiatry. 2015;72(2):136–142. doi:10.1001/jamapsychiatry.2014.1763
[2] American Geriatrics Society 2012 Beers Criteria Update Expert Panel. American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2012;60(4):616-631.
[3] C. H. Ashton, “Benzodiazepines: How They Work and How to Withdraw,” Institute of Neuroscience, Newcastle University, 2002. [Online]. Available: http://www.benzo. org.uk/manual/bzcha01.htm#15. [Accessed: 19-Dec-2017].
[4] Department of Health and Children, “Benzodiazepines : Good Practice Guidelines for Clinicians,” 2014. [Online]. Available: http://health.gov.ie/wp-content/uploads/2014/04/Benzodiazepines-Good-Practice-Guidelines.pdf. [Accessed: 27-Feb-2018]

Results:
Benzodiazepine overuse by year
Benzodiazepine overuse by socio-economic position (1-lowest, 4-highest) and sex


National Program for Quality Indicators in Community Healthcare
התכנית הלאומית למדדי איכות לרפואת הקהילה בישראל