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Benzodiazepine utilization in a university hospital
M H Zisselman1, B W Rovner, K G Kelly
1Department of Psychiatry and Human Behavior, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA.
Summary
Benzodiazepine use is common in hospitals, often without clear documentation. Prescribing patterns vary by service, race, and length of stay, with older patients receiving them as frequently as younger ones.
Area of Science:
- Pharmacology
- Hospital Medicine
- Medical Documentation
Background:
- Benzodiazepines are frequently prescribed in inpatient settings.
- Understanding utilization patterns and documentation is crucial for patient safety and quality of care.
Purpose of the Study:
- To evaluate the utilization of commonly prescribed benzodiazepines in hospitalized medical and surgical patients.
- To examine the relationship between benzodiazepine use and patient demographics, hospital service, and length of stay.
- To assess the documentation of indications for benzodiazepine prescriptions.
Main Methods:
- Retrospective review of 6,020 consecutive admissions from January to June 1992.
- Analysis of computerized hospital database and medical records.
- Examination of benzodiazepine use (Halcion, Ativan, Valium, Xanax) concerning age, race, sex, length of stay, and hospital service.
Main Results:
- Over 41% of patients received a benzodiazepine.
- Utilization was higher in surgical patients (49.0%) vs. medical (37.3%), and associated with white race and longer hospital stays.
- Medical records lacked documented indications for benzodiazepine use in 38.3% of cases, excluding preanesthetic use.
Conclusions:
- Benzodiazepines are widely prescribed in hospitals with inadequate documentation.
- Older patients receive benzodiazepines as frequently as younger patients, despite increased risks.
- Further research is needed on prescribing disparities by race, the impact of longer stays, and appropriate use in the elderly.