Benzodiazepine Utilization Review for Inpatients at a Tertiary Medical Center in Taiwan

Objectives:

To examine benzodiazepine prescribing patterns by physicians for inpatients relative to indications and drug characteristics in a tertiary medical center.

Design:

Prescription pattern analysis was done by checking computer-based pharmacy records. Benzodiazepine utilization was evaluated through retrospective chart review.

Results:

A total of 2,195 inpatients were surveyed, of whom 945 were given benzodiazepines. Of these, 827 charts were available for review. The mean number of prescriptions written for benzodiazepines was 1.62 per patient. Of the benzodiazepines available, triazolam was most frequently prescribed. The use of benzodiazepines ranged from 38.7% in the internal medicine ward to 85.1% in the oncology ward. We found that 60% of prescriptions were appropriate, 24.9% were prescribed without documentation, and 15.1% were used inappropriately.

Conclusions:

Proper prescribing of benzodiazepines is essential in the management of the symptoms of mental illness. From both a diagnostic and treatment perspective, more education efforts are needed in the investigation, documentation, and treatment of mental illness symptoms.

Geriatric psychopharmacology. A primary care challenge

Optimum therapy with psychopharmacologic agents in geriatric patients requires an appreciation of the elderly's increased predisposition to emotional disorders and their unique sensitivity to adverse drug-drug interactions. Although nonpharmacologic approaches should be considered, adjunctive use of psychoactive medications can assist the physician to break the "negative cycle" of emotional distress that often goes untreated in this age-group. Knowledge of which psychotropic medications are preferred for use in the elderly allows primary care physicians to make timely and successful therapeutic interventions. Consultation with a psychiatrist should be considered for complicated cases.