AIMS: To improve the use of benzodiazepines (BZD) in the elderly by a pharmacist-physician collaboration, and to insure that BZD are effective, safe, and used as long as necessary. DESIGN: A single blind controlled study was conducted on 11 pharmacies in the Community of Valencia. SETTING:Eleven pharmacies in the Community of Valencia. PARTICIPANTS: Patients older than 65 years treated with BZD attending the participating pharmacies. INTERVENTIONS: Interviews and pharmaceutical care for a year. MAIN MEASUREMENT: detection of duplications, adverse drug reactions, drug interactions and measuring the effectiveness of the treatment. RESULTS: We studied 314 patients, randomised to control or intervention and who used 346 BZD. The majority (67%) of patients used BZD for more than 1 year. Only 5% patients with anxiety knew the duration of treatment should be one month. Long-acting BZD were used by 20% of the patients, 76% used medium-acting (39% lorazepam and 37% other BZD) and 4% short-acting BZD. A total of 132 drug interactions were detected and 278 adverse drug reactions: 32% memory loss, 21% drowsiness, 12% lack of coordination, 8.3% dizziness and confusion, 8,3% disorientation and 10% others. A total of 426 pharmacist interventions were performed, 30 accepted by the doctor and 78 were resolved at the end of the year of study. Eleven per cent of cases were considered satisfactory in the control group and 30% in the intervention group. CONCLUSION: The use of benzodiazepines in the Community of Valencia exceeds the recommendations of the Spanish Medicines Agency.
RCT Entities:
AIMS: To improve the use of benzodiazepines (BZD) in the elderly by a pharmacist-physician collaboration, and to insure that BZD are effective, safe, and used as long as necessary. DESIGN: A single blind controlled study was conducted on 11 pharmacies in the Community of Valencia. SETTING: Eleven pharmacies in the Community of Valencia. PARTICIPANTS: Patients older than 65 years treated with BZD attending the participating pharmacies. INTERVENTIONS: Interviews and pharmaceutical care for a year. MAIN MEASUREMENT: detection of duplications, adverse drug reactions, drug interactions and measuring the effectiveness of the treatment. RESULTS: We studied 314 patients, randomised to control or intervention and who used 346 BZD. The majority (67%) of patients used BZD for more than 1 year. Only 5% patients with anxiety knew the duration of treatment should be one month. Long-acting BZD were used by 20% of the patients, 76% used medium-acting (39% lorazepam and 37% other BZD) and 4% short-acting BZD. A total of 132 drug interactions were detected and 278 adverse drug reactions: 32% memory loss, 21% drowsiness, 12% lack of coordination, 8.3% dizziness and confusion, 8,3% disorientation and 10% others. A total of 426 pharmacist interventions were performed, 30 accepted by the doctor and 78 were resolved at the end of the year of study. Eleven per cent of cases were considered satisfactory in the control group and 30% in the intervention group. CONCLUSION: The use of benzodiazepines in the Community of Valencia exceeds the recommendations of the Spanish Medicines Agency.
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