Prescribing benzodiazepines in residential aged-care facilities

Background: Benzodiazepines (BZDs) are used to treat sleep disturbances and behavioural and psychological symptoms of dementia in residents of aged-care facilities. Older people are vulnerable to the adverse effects of BZDs. In Australia,guidelines exist for prescribing BZDs,however there are a lack of data comparing prescribing patterns with guidelines. Aim: To review BZD prescribing patterns in residential aged-care facilities and to compare these with best-practice guidelines. Method: A cross-sectional analysis of BZD prescribing for residents aged 65 years and over was undertaken in 6 aged-care facilities. Data on patient demographics and BZD prescribing were obtained from medication charts,medical records and case notes. BZD prescribing patterns were compared to guidelines from the National Prescribing Service and Therapeutic Guidelines. Results: Prescribing data for 193 residents were analysed. 71 (37%) residents were prescribed a BZD,mostly temazepam and oxazepam. The majority of prescriptions complied with the guidelines w'ith respect to dose,but all exceeded the recommended duration of therapy. 55 (77%) residents had comorbidities for which guidelines recommended avoiding BZDs,such as a history of falls. Conclusion: Although the choice and dose of BZD were appropriate,prescribing did not adhere to guidelines because of the extended duration of therapy. Residents with comorbidities where BZDs should be avoided were frequently prescribed a BZD.