Abstract
Purpose: Benzodiazepines/z-hypnotics (BZD-Z) guidelines suggest that elderly people ought to use anxiolytic benzodiazepines (BZD) and z-hypnotics only at low dose and only for a short time, and that hypnotic BZD not should be used at all. Since the elderly aged 65-79 tend to be recently retired but still in relatively good health, they may have different needs for BZD-Z than those older or younger. Our objective is to examine BZD-Z use in this age group.Methods: The study population consisted of Norwegians, aged 65-79, who filled prescriptions for anxiolytic BZD, hypnotic BZD and/or z-hypnotics in 2004-2009. The quantities prescribed were in daily defined doses (DDD), and 100 DDD/year was deemed excessive.Results: More than a quarter of the population received at least one BZD-Z prescription each year. Half of those received more than 100 DDD/year and a quarter received over 250 DDD/year, with these proportions increasing year by year. All three subgroups of BZD-Z showed increasing use with age and all except anxiolytic BZD showed increasing proportions of users using more than 100 DDD/year with age.Conclusions: Substantial numbers of elderly aged 65-79 receive prescriptions for BZD-Z, more with increasing age, and greater amounts per user. Guidelines are clearly ignored. While a rigid enforcement of guidelines/rules is not the answer, allowing the status quo to continue shows lack of respect for guidelines.
Highlights
Benzodiazepines and z-hypnotics (BZD-Z) have received a great deal of attention from clinical authorities and researchers regarding proper use.[1,2] This has led to clinical guidelines and recommendations which can be used to group BZD-Z use into appropriate and inappropriate use categories
Every year almost 30% of the Norwegian population filled at least one prescription for BZD-Z with most of the prescriptions being for z-hypnotics
Anxiolytic BZD and hypnotic BZD were used by smaller proportions of the population
Summary
Benzodiazepines and z-hypnotics (BZD-Z) have received a great deal of attention from clinical authorities and researchers regarding proper use.[1,2] This has led to clinical guidelines and recommendations which can be used to group BZD-Z use into appropriate and inappropriate use categories. Research has shown that many elderly use BZD-Z contrary to recommendations.[4,5,6,7,8] One would hope that after many warnings and repeated emphasis on limiting use, at least see some trend towards improvement in use would be seen. Our study population will be limited to persons aged 65-79 as opposed to those younger or older. Separating this age group from those younger and those older takes into account the unique features of this age group. People are more likely to suffer from chronic illnesses or reside in nursing homes
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