Gerlach et al identified risk factors for long-term benzodiazepine use in an older adult. These can help to identify a patient who may benefit from interventions to avoid prolonged use. The authors are from the University of Michigan, VA Ann Arbor Healthcare System, Corporal Michael J. Crescenz VA Medical Center and the University of Pennsylvania.
Patient selection: older adult (mean 78 years with standard deviation 7 years; will use > 65 in the implementation)
Prescriber: non-psychiatrist clinician
Outcome: continued use 1 year after initial prescription
Risk factors for long-term use:
(1) White race (odds ratio 4.2)
(2) very bad sleep quality (odds ratio 4.1)
(3) duration of the initial prescription (odds ratio 1.9 for each additional 9.7 days)
Recommendations:
(1) Keep the number dispensed as low as possible.
(2) Emphasize that therapy is going to be short term.
(3) Identify other interventions to address poor sleep quality.
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