General practitioners' prescribing patterns of benzodiazepine hypnotics: are elderly patients at particular risk for overprescribing? A report from the Møre & Romsdal Prescription Study.

OBJECTIVE

To compare general practitioners' (GPs) prescribing patterns of benzodiazepine hypnotics with current recommendations.

DESIGN

Observational, cross-sectional study.

SETTING

The Norwegian county Møre and Romsdal.

SUBJECTS

3452 prescriptions for benzodiazepine hypnotics prescribed by GPs for patients aged 20 years and older during two months.

MAIN OUTCOME MEASURES

Prescriptions (strength of tablets, amount prescribed given in Defined and Prescribed Daily Doses: DDDs and PDDs, directions for use); initial or repeat, patients (age, sex); kind of GP-patient contact during prescribing.

RESULTS

68.4% of the prescriptions for benzodiazepine hypnotics were for women; 52.7% were for patients aged 65 or older (65+); 59.9% were issued during indirect contacts; 81.9% were repeat prescriptions. The amount of drug per prescription increased with patients' age: 65+ received on average 69.9 DDDs (76.9 PDDs) per prescription compared with 34.4 DDDs (37.1 PDDs) for young adults (20-29 years). About four of five prescriptions were for the "strong" (i.e. 1 tablet = 1 DDD) sleeping pills irrespective of patients' age and type of prescription (initial or repeat). Written directions for use were: "to be taken daily" in 55.1%, and "only if required" in 38.0% of the prescriptions. Written information on duration of "cure" was only found in one case.

CONCLUSIONS

GPs' prescribing patterns are not in accordance with recommended dosage and duration of treatment; this pattern is most pronounced for elderly patients.