Reducing Inappropriate Benzodiazepine Use among Older Adults
Benzodiazepine (ben-zo-di-'a-z?-pen) use in the United States is common and increases with age, used by 8.7% of patients aged 65-80 years.1 Benzodiazepines?which include well-known medications such as Xanax, Ativan, and Klonopin?are most commonly used for anxiety and insomnia, even though psychotherapy and alternative medications are now recommended preferentially over benzodiazepines.2-4 Use is a particular concern among older adults, given the links between benzodiazepine prescribing and a variety of adverse outcomes including falls5, fractures6 and motor vehicle accidents.7 Co-prescribing of benzodiazepines and opioids is particular cause for concern: their use together was subject of a new black box safety warning from the US Food and Drug Administration in late 2016 for increased risk of respiratory suppression and death.
Attempts to reduce benzodiazepine use have met with limited success in the real world, as patients are reluctant to consider the possibility of stopping them and providers are reluctant to even suggest the possibility. In the course of a brief return visit in primary care, providers simply do not have the time or incentive to engage in a potentially difficult, lengthy discussion with patients about reducing or stopping their benzodiazepine.
Centers for Medicare and Medicaid Services
(subcontract: MA No. 20180230-00 / Project # E20182782-00)
Funding Period: 10/1/2017 to 9/30/2018