Deprescribing Benzodiazepines in Older Adults

Abstract

Benzodiazepines are well established as having the ability to produce rapid relief of anxiety and sleep disorders. However, despite their association with harm and often-short therapeutic effects, they continue to be prescribed often. Through the process of aging, the accumulation of medications needed to treat various disease states contributes to polypharmacy among the elderly. Older adults have unique factors that position them at a higher susceptibility of the anticholinergic side effects of benzodiazepines, which can result in falls, cognitive impairments and depression. Given these concerns, multiple professional organizations have identified the deprescribing of benzodiazepines as a national public health priority and have strongly recommended the pursuit of alternative shared decision-making approaches. While non- pharmacologic techniques are widely recognized to safely manage the common reasons clinicians provide when choosing to prescribe benzodiazepine’s, there is a mounting need for prescriber education regarding these practical approaches as well as evidence-based clinical practice guidelines to support successful deprescribing [1]. The purpose of this DNP project was to improve prescriber knowledge of deprescribing approaches and present alternative prescribing decisions through participation of an evidence-based education program at a geriatric specialized, primary care practice in Pennsylvania. The study participants consisted of Physicians, Nurse Practitioners and Physician Assistants who prescribe benzodiazepines. The results indicated an improvement in the participant’s knowledge of deprescribing approaches and alternative prescribing choices, as evidenced by how they rated their attitudes, knowledge and practices after participating in the evidence-based education.