Skip to main content
SpringerLink
Log in

Chronic benzodiazepine usage among older people: prevalence, indications, and treatment modifications in patients admitted to an acute geriatric unit

  • Brief Report
  • Published:
European Geriatric Medicine Aims and scope Submit manuscript

    We’re sorry, something doesn't seem to be working properly.

    Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

Key summary points

AbstractSection Aim

To study the prevalence and indication for benzodiazepines (BZD) usage in older adults admitted to an acute geriatric unit. To analyze changes made to that treatment at discharge and to check its reintroduction 3 months later.

AbstractSection Findings

A quarter of patients took BZD chronically, most of them with no clinical indication. Upon discharge, BZD were discontinued or reduced in most patients. However, this process is not continued in the outpatient setting.

AbstractSection Message

The process of deprescribing BZD is complex and challenging as our study underscores. Hospitalization in an acute geriatric unit may be an opportunity to start deprescription. Nevertheless, it is essential to implement general recommendations to continue this process after discharge.

Abstract

Aim

To investigate the prevalence and indications of benzodiazepines (BZD) usage among patients admitted to an acute geriatric unit and assess changes in prescriptions.

Methods

BZD indications were documented reviewing clinical records, with appropriateness assessed based on the STOPP–START criteria. Changes in BZD prescriptions were recorded at discharge and 3 months later.

Results

Among the 366 patients included (mean age: 92.8 years, 68% females), 91 (24.9%) were on BZD upon admission, being inappropriate in 93.4%. At discharge, BZD discontinuation was observed in 40.7% and dose reduction initiated in 57.4%. Among patients discharged without prescriptions, 10.8% resumed their use at 3 months. Of those discharged with BZD tapering, 74.1% were still on them 3 months later.

Conclusions

The majority of patients employing BZD lacked a medical indication. Admission to a geriatric ward resulted in successful discontinuation or dose reduction for most patients but was not maintained in the outpatient setting.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  1. Gerlach LB, Wiechers IR, Maust DT (2018) Prescription benzodiazepine use among older adults: a critical review. Harv Rev Psychiatry 26(5):264–273. https://doi.org/10.1097/HRP.0000000000000190

    Article  PubMed  PubMed Central  Google Scholar 

  2. Airagnes G, Pelissolo A, Lavallée M, Flament M, Limosin F (2016) Benzodiazepine misuse in the elderly: risk factors, consequences, and management. Curr Psychiatry Rep 18(10):89. https://doi.org/10.1007/s11920-016-0727-9

    Article  PubMed  Google Scholar 

  3. Markota M, Rummans TA, Bostwick JM, Lapid MI (2016) Benzodiazepine use in older adults: dangers, management, and alternative therapies. Mayo Clin Proc 91(11):1632–1639. https://doi.org/10.1016/j.mayocp.2016.07.024

    Article  CAS  PubMed  Google Scholar 

  4. Xing D, Ma XL, Ma JX, Wang J, Yang Y, Chen Y (2014) Association between use of benzodiazepines and risk of fractures: a meta-analysis. Osteoporos Int 25(1):105–120. https://doi.org/10.1007/s00198-013-2446-y. (Epub 2013 Sep 7)

    Article  CAS  PubMed  Google Scholar 

  5. Seppala LJ, Wermelink AMAT, de Vries M, Ploegmakers KJ, van de Glind EMM, Daams JG, van der Velde N (2018) EUGMS task and Finish group on fall-risk-increasing drugs. Fall-risk-increasing drugs: a systematic review and meta-analysis: II. Psychotropics. J Am Med Dir Assoc 19(4):371.e11-37117. https://doi.org/10.1016/j.jamda.2017.12.098

    Article  PubMed  Google Scholar 

  6. Díaz-Gutiérrez MJ, Martínez-Cengotitabengoa M, Sáez de Adana E, Cano AI, Martínez-Cengotitabengoa MT, Besga A, Segarra R et al (2017) Relationship between the use of benzodiazepines and falls in older adults: a systematic review. Maturitas 101:17–22. https://doi.org/10.1016/j.maturitas.2017.04.002. (Epub 2017 Apr 5)

    Article  CAS  PubMed  Google Scholar 

  7. Palmaro A, Dupouy J, Lapeyre-Mestre M (2015) Benzodiazepines and risk of death: results from two large cohort studies in France and UK. Eur Neuropsychopharmacol 25(10):1566–1577. https://doi.org/10.1016/j.euroneuro.2015.07.006. (Epub 2015 Jul 29)

    Article  CAS  PubMed  Google Scholar 

  8. Gomez CJ, Quinones AD, Gonell AM, Sani TN, Ysea-Hill O, Baskaran D, Ruiz JG (2022) The cross-sectional association of frailty with chronic past and current use of benzodiazepine drugs. Aging Clin Exp Res 34(8):1837–1843. https://doi.org/10.1007/s40520-022-02125-9. (Epub 2022 May 6)

    Article  PubMed  Google Scholar 

  9. Delgado Silveira E, Montero Errasquín B, Muñoz García M, Vélez-Díaz-Pallarés M, Lozano Montoya I, Sánchez-Castellano C, Cruz-Jentoft AJ (2015) Mejorando la prescripción de medicamentos en las personas mayores: una nueva edición de los criterios STOPP-START [Improving drug prescribing in the elderly: a new edition of STOPP/START criteria]. Rev Esp Geriatr Gerontol 50(2):89–96. https://doi.org/10.1016/j.regg.2014.10.005. (Epub 2014 Nov 22)

    Article  CAS  PubMed  Google Scholar 

  10. By the 2023 American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052–2081. doi: https://doi.org/10.1111/jgs.18372.

  11. Van Poelgeest EP, Seppala LJ, Lee JM, Bahat G, Ilhan B, Lavan AH, Mair A, EuGMS SIG Pharmacology et al (2022) Deprescribing practices, habits and attitudes of geriatricians and geriatricians-in-training across Europe: a large web-based survey. Eur Geriatr Med. 13(6):1455–1466. https://doi.org/10.1007/s41999-022-00702-9. (Epub 2022 Nov 2)

    Article  PubMed  PubMed Central  Google Scholar 

  12. Sibille FX, Spinewine A, Zerah L, Maljean L, Schoevaerdts D, de Saint-Hubert M (2022) Current practice in benzodiazepine receptor agonists deprescribing on acute geriatric wards: a cohort study. BMC Geriatr 22(1):88. https://doi.org/10.1186/s12877-022-02753-w

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Sibille FX, de Saint-Hubert M, Henrard S, Aubert CE, Goto NA, Jennings E, Dalleur O et al (2023) Benzodiazepine receptor agonists use and cessation among multimorbid older adults with polypharmacy: secondary analysis from the OPERAM trial. Drugs Aging 40(6):551–561. https://doi.org/10.1007/s40266-023-01029-1. (Epub 2023 May 23)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Reeve E, Ong M, Wu A, Jansen J, Petrovic M, Gnjidic D (2017) A systematic review of interventions to deprescribe benzodiazepines and other hypnotics among older people. Eur J Clin Pharmacol 73(8):927–935. https://doi.org/10.1007/s00228-017-2257-8. (Epub 2017 Apr 30)

    Article  CAS  PubMed  Google Scholar 

  15. Ng BJ, Le Couteur DG, Hilmer SN (2018) Deprescribing benzodiazepines in older patients: impact of interventions targeting physicians, pharmacists, and patients. Drugs Aging 35(6):493–521. https://doi.org/10.1007/s40266-018-0544-4

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

This work was not supported by any institution.

Author information

Authors and Affiliations

  1. Servicio de Geriatría, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain

    C. Corral-Tuesta, A. Rodríguez Díaz-Pavón, B. Montero-Errasquín, C. G. Álvarez-Pinheiro, V. Lavilla-Gracia & A. J. Cruz-Jentoft

Authors
  1. C. Corral-Tuesta
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Rodríguez Díaz-Pavón
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B. Montero-Errasquín
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. G. Álvarez-Pinheiro
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. V. Lavilla-Gracia
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A. J. Cruz-Jentoft
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. Corral-Tuesta.

Ethics declarations

Conflict of interest

The authors declare no conflicts of interest.

Ethical approval

The current study was performed according to the ethical recommendations outlined in the Declaration of Helsinki. The drug Research Ethics Committee of the hospital where the study was conducted (CEIm) approved this study (approval number 002–20).

Informed consent

For this study, informed consent was not necessary.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Corral-Tuesta, C., Rodríguez Díaz-Pavón, A., Montero-Errasquín, B. et al. Chronic benzodiazepine usage among older people: prevalence, indications, and treatment modifications in patients admitted to an acute geriatric unit. Eur Geriatr Med 15, 539–543 (2024). https://doi.org/10.1007/s41999-023-00918-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s41999-023-00918-3

Keywords

Search

Navigation