Cayetana de Miguel de Juanes and Pilar Rodriguez Ledo.
More and more voices are being heard from experts who warn about possible consumption in benzodiazepine excess in our country, which may have been seen increased by the SARS-CoV-2 pandemic with secondary increased pathologies such as anxiety, depression and insomnia. This is the opinion of the authors of the study, which won the prize for the best communication of internal medicine residents at the XXVIII National Congress of the Spanish Society of General and Family Physicians (SEMG).
The researchers confirmed in their investigation that population over 65 years old consumes them in high percentage, being more susceptible to adverse effects. In this sense, the authors of this study warn that “excessive consumption in the elderly population, together with use without medical supervision, leads to risks arising from its side effects such as sedation, dizziness, drowsiness or falls, among others, which can worsen the baseline situation of the elderly, reducing their quality of life and increasing their morbidity,” according to Cayetana De Miguel de Juanes, family medicine resident.
In addition, “there is significant reluctance on the part of patients to stop these drugs, despite the explanation that they create a lot of tolerance and a lot of dependence.” To avoid reaching this type of situation, De Miguel believes they must “improve use of non-pharmacological measures to treat patient-reported symptoms’, such as optimizing sleep hygiene-dietary measures, relaxation exercises for anxiety or emotion management tools. However, “the problem with this, as with many other aspects, is time. And that’s it implementing these recommendations takes more than the time we have per patient; but we should not think that this is time lost, but rather time invested in reducing side effects and polypharmacy”.
The authors also bet on establish a benzodiazepine weaning protocol along with breastfeeding and limiting long-term use, avoiding the chronic pattern in the e-prescription, and reviewing this drug on a monthly basis.
With work presented in June at SEMG’s national convention, they also aim to raise awareness among the general public, as well as among professionals, “of the problem that leads to this excessive consumption, which in some patients can be considered an addiction,” according to Cayetana de Miguel de Juanes. The other authors of the award-winning study are Ana Alesón Andres, Cristina Ruiz de Loisaga García, Miguel Quintanilla Arajuetes, Rafael Sabariego Redondo and Rocio Arias Rubio.
Objectives of the study
The main objective was to know the percentage of patients older than 65 years registered at the Reyes Magos Health Center in Alcalá de Henares (Madrid) with a potentially inappropriate prescribing of benzodiazepines according to the STOPP/START criteria from the 2014 update, from October 2020 to October 2021.
Secondary objectives were to know the demographic profile of the population by age and gender The most commonly prescribed benzodiazepines based on their half-life (short, intermediate and long) and the percentage of patients who, in addition to the potentially inappropriate prescription of benzodiazepines, were prescribed another drug with a similar effect (antidepressants, hypnotics and neuroleptics).
The most remarkable results
In relation to the demographic profile, they observed that prescribing was more common in women with 72.1 percent. Regarding the age at which they were prescribed, they did not find large differences, with 50.5% in patients between 65-75 years and 49.5 percent in patients over 75 years of age.
As for the reason for the prescription, they found that the two most common reasons were anxiety and insomnia with 51.3% and 51.9% respectively, followed by depression (36.1%) and agitation (7.2%). Only 14.4% of prescriptions were due to other unrecorded reasons.
Regards to a type of prescribed benzodiazepinewere the middle-aged ones intermediate the most frequently prescribed, up to 50.9 percent, those with a short half-life in 43.7 percent, and the least prescribed were those with a long half-life, in only 15.3 percent of patients. In addition, they noted that up to 11.5 percent of patients were prescribed at least two concomitant benzodiazepines. Regarding whether these patients had associations with other psychotropic drugs, the results were that 41.3% were treated with antidepressants, 8.2% with hypnotics and 4.3% with antipsychotics.
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