A ten-year retrospective comparison of benzodiazepine usage between rural and urban residents of Newfoundland and Labrador

Background: Benzodiazepines are believed to be one of the most overprescribed medications worldwide. Inappropriate prescribing of benzodiazepines can lead to serious adverse effects including cognitive impairment, falls in the elderly, and decreased motor function. Guidelines have been developed to address overprescribing, however analysis of prescribing patterns before and after implementing these guidelines shows inappropriate use is still present. Objectives: This thesis examined benzodiazepine prescribing patterns in a sample of Newfoundland patients. Various definitions for inappropriate prescriptions were used: within 30, 45 and 60 days of previous prescription. Comparisons were assessed between rural and urban areas of Newfoundland, Canada. Methods: Patients with a benzodiazepine prescription between 2007 and 2017, through the Newfoundland and Labrador Prescription Drug Program, were included in this study. Descriptive statistics were used to describe prescribing patterns. Regression analyses were used to examine the association between prescribing / usage and age, sex, prescriber specialty and location of residence (urban / rural). Results: Using the various definitions for inappropriate prescribing, the rate of inappropriate prescribing was between 71.7% and 74.9%. Individuals in urban areas had a higher quantity of inappropriate prescriptions, less than 30 days apart, compared to those in rural areas. Additionally, the percentage of inappropriate prescriptions did not decrease during the ten-year timeframe examined. Conclusions: Inappropriate prescribing remained prevalent in a Newfoundland and Labrador sample. Results from this study highlight that we need to remain vigilant pursuing strategies that encourage appropriate prescribing of this drug class