Prevalence and factors associated with the use of benzodiazepines in elderly in a specialized ambulatory in Porto Alegre, Brazil

Keywords: aged, geriatric psychiatry, benzodiazepine receptor, potentially inappropriate medication list

Abstract

Aims: to verify the prevalence of BZDs use in the elderly population treated at an outpatient clinic for geriatric psychiatry at a university hospital in Porto Alegre, Brazil.
Methods: cross-sectional study carried out at the geriatric psychiatric outpatient clinic. Data collection occurred during the first consultation of individuals aged 60 years or over. The evaluated data comprise sociodemographic, clinical, health and medication use issues. For statistical analysis the SPSS program (in English, Statistical Package for the Social Sciences) was used.
Results: a total of 295 elderly people were included in the study. The average age was 72.1 ± 8.3 years, mostly women (76.6%), with schooling from 5 to 8 and 9 to 12 years of study (both with the same frequency, 28.9%), married (45.0%), living with a family member (34.4%), retired (79.8%). The prevalence of BZDs use was 33.6% (n = 99). The main complaint of anxiety and the diagnosis of anxiety disorders were associated with the use of BZDs.
Conclusions: the prevalence of the use of BZDs was high and associated with the main complaint of anxiety and the diagnoses of anxiety and depressive disorders, even though these are considered potentially inappropriate medications and with a high risk of complications. The treatment of the geriatric population is often placed in the background, not properly receiving care directed to the specific demands that these individuals need. The epidemiological knowledge of the elderly population exposes characteristics and assists in the development of a differentiated therapeutic plan.

Downloads

Download data is not yet available.

Author Biographies

Isabella Serafin Couto, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brasil.

Médica pela Universidade do Extremo Sul Catarinense (UNESC), em Criciúma, SC, Brasil; especialista em Psiquiatria pela Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), em Porto Alegre, RS, Brasil.

Vanessa Sgnaolin, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brasil.

Doutora em Gerontologia Biomédica pela Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), em Porto Alegre, RS, Brasil; mestre em Medicina e Ciências da Saúde pela Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), em Porto Alegre, RS, Brasil.

Paula Engroff, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brasil.

Doutora em Gerontologia Biomédica pela Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), em Porto Alegre, RS, Brasil.

Letícia Güenter Dannebrock, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brasil.

Médica pela Universidade Luterana do Brasil (ULBRA), em Canoas, RS, Brasil; especialista em Psiquiatria pela Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), em Porto Alegre, RS, Brasil.

Luiz Gustavo Guilhermano, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brasil.

Mestre em Farmacologia pela Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), em Porto Alegre, RS; Psiquiatra Titular da Associação Brasileira de Psiquiatria (ABP), em Rio de Janeiro, RJ; professor da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), em Porto Alegre, RS, Brasil.

Alfredo Cataldo Neto, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brasil.

Doutor em Medicina e Ciências da Saúde pela Pontifícia Universidade Católica Do Rio Grande do Sul (PUCRS), em Porto Alegre, RS, Brasil; professor da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), em Porto Alegre, RS, Brasil.

References

Active ageing: A policy framework [Internet]. Genebra: World Health Organization. 2002 [cited 2020 Out 25]. Available from: https://apps.who.int/iris/handle/10665/67215.

World Population Prospects [Internet]. New York: United Nations. 2019 [cited 2020 Out 25]. Available from https://population.un.org/wpp.

Síntese de indicadores sociais: uma análise das condições de vida da população brasileira, 2017 [Internet]. Rio de Janeiro: Instituto Brasileiro de Geografia e Estatística. 2017 [cited 2020 Out 15]. Available from: https://biblioteca.ibge.gov.br/visualizacao/livros/liv101459.pdf.

Perissé C, Marli M. Caminhos para uma melhor idade. Retratos a revista do IBGE. 2019, 16:18-27.

By the 2019 American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2019;67(4):674-94.

Organização Mundial da Saúde. La salud mental y los adultos mayores. Genebra: World Health Organization; 2017.

Iaboni A, et al. Changing Pattern of Sedative Use in Older Adults: A Population-Based Cohort Study. Drugs & aging. 2016;33(7):523-33.

Alvarenga JM, et al. Prevalence and sociodemographic characteristics associated with benzodiazepines use among community dwelling older adults: the Bambuí Health and Aging Study (BHAS). Revista Brasileira de Psiquiatri. 2008;30(1):7-11.

Sgnaolin V, et al. Patterns of chronic benzodiazepine use in the elderly. Rev Psiquiatr Clín. 2016;43(4):79-82.

American Psychiatric Association. DSM-5: Manual diagnóstico e estatístico de transtornos mentais. Porto Alegre: Artmed Editora; 2014.

Torres-bondia F, et al. Trends in the consumption rates of benzodiazepines and benzodiazepine-related drugs in the health region of Lleida from 2002 to 2015. BMC Public Health. 2020;20(1):818.

Oliveira ALML. Estudo de tendência do uso de benzodiazepínicos entre idosos residentes no município de Bambuí, Minas Gerais [dissertação]: Programa de Pós-Graduação em Ciências da Saúde, Instituto René Rachou, Fundação Oswaldo Cruz; 2018. 61 f. Disponível em: https://www.arca.fiocruz.br/handle/icict/34254.

Airagnes G, et al. Benzodiazepine Misuse in the Elderly: Risk Factors, Consequences, and Management. Curr Psychiatry Rep. 2016;18(10):89.

Subramanyam A A, et al. Clinical practice guidelines for Geriatric Anxiety Disorders. Indian Journal of Psychiatry. 2018; 60(suppl. 3):S371-S382.

Olfson M, King M, Schoenbaum M. Benzodiazepine Use in the United States. JAMA Psychiatry. 2015;72(2):136.

Borja-oliveira C R, Assato C P. Psicofármacos potencialmente inapropriados para idosos. Estud Interdiscipl Envelhec. 2015;20(3):687-701.

Costa COD, et al. Prevalência de ansiedade e fatores associados em adultos. J Bras Psiquiatr. 2019;68(2):92-100.

Kinrys G, Wygant L. E. Anxiety disorders in women: does gender matter to treatment? Braz J Psychiatry. 2005; 27(suppl 2):S43-50.

Cook JM, Biyanova T., Marshall R. Medicating Grief With Benzodiazepines: Physician and Patient Perspectives. Arch Intern Med. 2007;167(18):2006-7.

Manthey L, et al. Correlates of (inappropriate) benzodiazepine use: the Netherlands Study of Depression and Anxiety (NESDA). Br J Clin Pharmacol. 2011;71(2):263-72.

Boehlen FH, et al. Gender-specific predictors of generalized anxiety disorder symptoms in older adults: Results of a large population-based study. J Affect Disord Rep. 2020; 262:174-81.

Nardi TC, Grassi-Oliveira R., Pádua AC. Terapia Cognitivo- Comportamental no Tratamento dos Sintomas de Ansiedade em Idosos. In: Freitas ER, Barbosa AJG, Neufeld CB, org. Terapias cognitivo-comportamentais com idosos. Novo Hamburgo: Sinopsys; 2016.

Kennedy SH, et al.; CANMAT Depression Work Group. Clinical guidelines for the treatment of depressive disorders. Can J Psychiatry. 2001;46(suppl 1):5S-90S.

Carrasco-Garrido P, et al. Psychotropics use in the Spanish elderly: predictors and evolution between years 1993 and 2003. Pharmacoepidemiol Drug Saf. 2007;16(4):449-57.

Richardson K, Bennett K, Kenny RA. Polypharmacy including falls risk increasing medications and subsequent falls in community-dwelling middle-aged and older adults. Age Ageing. 2015;44:90-6.

Bloomfield HE, et al. Deprescribing for Community- Dwelling Older Adults: a Systematic Review and Meta-analysis. J Gen Intern Med. 2020;35(11):3323-32.

Published
2021-10-20
How to Cite
Couto, I. S., Sgnaolin, V., Engroff, P., Dannebrock, L. G., Guilhermano, L. G., & Neto, A. C. (2021). Prevalence and factors associated with the use of benzodiazepines in elderly in a specialized ambulatory in Porto Alegre, Brazil. PAJAR - Pan American Journal of Aging Research, 9(1), e40298. https://doi.org/10.15448/2357-9641.2021.1.40298