The cascade of benzodiazepine prescribing for hospitalized geriatric patients

Journal of Community Hospital Internal Medicine Perspectives
Neshahthari WijeyakuhanNicholas A Rattray

Abstract

Hospitalists increasingly provide care for geriatric patients and little is known about the extent to which hospitalists adhere to evidence-based medication guidelines. This study aimed to characterize hospitalist adherence to BEERS guidelines for prescribing and monitoring benzodiazepines for older adults. We conducted a retrospective chart review of admitted patients aged 70-85 years who had been prescribed benzodiazepine. Charts from 351 patients were analyzed for documentation and decision rationale, which included 638 separate notes. Benzodiazepines were prescribed 28.2% of the time to address anxiety, which is inconsistent with the BEERS criteria; 39% had adequate data in the impression and plan section of the note to reflect why benzodiazepine was prescribed. Of note, the majority of notes had partial or missing data. Physicians tended to follow guidelines more than advance practice providers. Wide variation persists in prescribing practices and documentation related to benzodiazepines and both could potentially be addressed with further training.

References

Sep 12, 1998·Annals of Internal Medicine·W J Hall
Oct 25, 2000·International Journal of Geriatric Psychiatry·G M BattyS H Jackson
Dec 7, 2007·Annals of Internal Medicine·Daniel S BudnitzChesley L Richards
Aug 27, 2013·Gerontology & Geriatrics Education·Susan M FriedmanRobert M McCann
Nov 27, 2014·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Shannon M DeanLeigh Anne Bakel
May 1, 2015·Annals of Internal Medicine·Randall J Morse, Catherine E DuBeau
Oct 9, 2015·Journal of the American Geriatrics Society·UNKNOWN By the American Geriatrics Society 2015 Beers Criteria Update Expert Panel
Apr 10, 2018·Archives of Gerontology and Geriatrics·Liron SinvaniRenee Pekmezaris
Jan 30, 2019·Journal of the American Geriatrics Society·UNKNOWN By the 2019 American Geriatrics Society Beers Criteria® Update Expert Panel
Oct 2, 2019·Journal of the American Geriatrics Society·Peter J HuckfeldtJoseph G Ouslander

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