A retrospective study of chart review for the use of benzodiazepines and related drugs among patients with dementia

Objective: Benzodiazepines and related drugs (BZDRs) increase the risk of undesirable health outcomes in the elderly and should be prescribed judiciously. In this study, we intended to evaluate the prevalence of BZDRs among patients with dementia and to identify the risks associated with BZDR use. Methods: This study was conducted at a public psychiatric hospital in northern Taiwan. Patients with Taiwan National Health Insurance catastrophic illness certificate of dementia were recruited. We reviewed their medical records for a two-year period since the issued date of patients' certificates. Results: The prevalence of BZDRs among the patients with dementia was up to 49% (151/308). The most popular BZDRs in this study were estazolam (16.2%), followed by zopiclone (11.4%) and zolpidem (7.5%). The most common adverse events (AEs) related to BZDRs were delirium (6.0%), followed by somnolence (4.6%) and fall (2.0%). Patients with physical comorbidities had significantly higher risk of BZDR-related AEs compared to those without physical comorbidities (adjusted odds ratio = 2.097, 95% confidence interval = 1.225–3.589, p < 0.05). Conclusion: In this study, we identified that BZDRs were highly prevalent in patients with dementia and physical comorbidities, that BZDRs were associated with higher risk of AEs, and that delirium, somnolence, and fall were common AEs during the period of BZDR treatment. Clinicians should be aware of the AEs of BZDRs and prescribe BZDRs carefully for older-demented patients