A national study of benzodiazepine and z-hypnotic prescribing for older people

Johnson, Chris F and Frei, Cornelia and Downes, Noreen and McTaggart, Stuart A and Akram, Gazala (2016) A national study of benzodiazepine and z-hypnotic prescribing for older people. British Journal of General Practice, 66 (647). e410-e415. ISSN 0960-1643

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Abstract

Overall benzodiazepine and z-hypnotic (B&Z) prescribing has slowly reduced over the last 20 years. However long-term prescribing still occurs, particularly amongst older people, and this is at odds with prescribing guidance.Aim: To compare B&Z prescribing between care home and non-care home residents ≥65 years old.  Cross sectional population based study, primary care, Scotland.  National patient-level B&Z prescribing data, for adults aged ≥65 years, were extracted from Prescribing Information System (PIS) for calendar year 2011. PIS gives access to data for all National Health Service prescriptions dispensed inprimary care in Scotland. Data were stratified by health board, residential status, gender and age (65-74, 75-84 and ≥85 years). To minimise disclosure risk, data from smaller health boards were amalgamated according to geography, thereby reducing the number from 14 to 10 areas.  17% (n=879,492) of the Scottish population were ≥65 years, of which 3.7% (n=32,368) were care home residents. 12.1% (n=106,412) of older people were prescribed one or more B&Z; 5.9% an anxiolytic, 7.5% a hypnotic, and 1.3% prescribed both.28.4% (9,199) of care home and 11.5% (97,213) of non-care home residents were prescribed B&Zs, Relative Risk 2.88, 95% CI, 2.82 to 2.95, p<0.001. Estimated annual B&Z exposure reduced with increasing care home residents’ age, whereas non-care home residents’ exposure increased with age.  B&Zs were commonly prescribed for older people, with care home residents three times more likely to be prescribed B&Zs than non-care home residents. However, overall B&Z exposure amongst non-care home residents’ was found to rise with increasing age.