Differences in Benzodiazepine Receptor Agonist Use in Rural and Urban Older Adults

Abstract

Background: Older adults are especially susceptible to adverse consequences of potentially inappropriate medications (PIMs), such as benzodiazepine receptor agonists (BZDRAs), due to age-related pharmacokinetic and pharmacodynamic changes. Although some risk factors for BZDRA use in older adults have been identified, the role of rural versus urban residence is less clear. Objective: To describe BZDRA use in rural versus urban older adults using pharmaceutical claims from Pennsylvania’s Pharmaceutical Assistance Contract for the Elderly (PACE) program. Methods: The sample consisted of older adults enrolled in Pennsylvania’s Healthy Steps for Older Adults and participated in Pennsylvania’s PACE program. Independent sample t tests and contingency tables were used to examine residence differences. Multivariate binary logistic modeling was performed. Results: The total sample (N = 426) was 305 (71.6 %) urban-dwelling adults and 121 (28.4 %) rural-dwelling adults. Rural participants were more likely to be male, white, married, and have less than a high school education compared with urban participants (p