Drug utilization review on benzodiazepines for the elderly Korean inpatients

Abstract

Background: This study was carried out for conducting the drug utilization review of oral benzodiazepines for geriatric patients that are frequently prescribed in geriatric practice and associated with many serious side effects in elderly people. Method: The subjects of this study were the 'Korean Elderly Pharmacoepidemiology Cohort', who were the beneficiaries of Korea Medical Insurance Corporation in 1993 and 1994, over 65 years of age, lived in Pusan metropolitan city. The information about prescribed for benzodiazepines was constructed from the medical claims data, and they included personal identification age, sex, the name of drug, dosage, the date of prescription and the medical institution where the patient admitted. Result: The total number of cases prescribed for benzodiazepines from 1993 to 1994 were 1,518. 988 cases were for female and 530 cases were for male. The most frequently prescribed benzodiazepine was diazepam (59.1%) and the total prescription proportion of long acting benzodiazepines was 70.8%. The doses of benzodiazepines were almost optimal exept alprazolam which was overdosed somewhat according to geriatric prescription guideline. There was decreasing tendency of diazepam prescription and increasing tendency of lorazepam for 2 years. Conclusion: The use of benzodiazepins with a long duration of action in elderly people are associated with an increased risk of falling and fracture that leads to the decrease of quality of life. So, long half-life benzodiazepines should be prescribed more cautiously in geriatric practice.