Development of an indicator to identify inappropriate use of benzodiazepines in elderly medical in-patients

Abstract

Studies reporting the quantity of benzodiazepines used are purely descriptive and cannot comment on the quality or appropriateness of prescribing benzodiazepines. An indicator to assess the appropriateness of prescribing benzodiazepines was developed from published literature. The applicability of the indicator was discussed in a multidisciplinary forum. The indicator uses clinical data currently available to the prescriber. The indicator, in the form of an algorithm, was applied to assess the appropriateness of prescribing of benzodiazepines to medical in-patients aged < or =65 years at 17 hospitals in England and Wales. Prescribing data were collected on 1391 patients. Appropriateness of prescribing of 311 benzodiazepines were assessed. Benzodiazepines were prescribed appropriately for 110/311 (35%) prescriptions and inappropriately for 201/311 (65%) prescriptions. Initiation of benzodiazepine for no acceptable indication was the commonest reason for inappropriate prescribing. The instrument identifies the appropriateness of prescribing of benzodiazepines and can be utilised by non-physicians.