A new study within the Veterans Health Administration system aimed to identify strategies to reduce benzodiazepine prescriptions for older adults. This is important because benzodiazepines have been known to impair cognition, mobility and driving skills in older people, as well as increase the risk of falls. Unlike many community-based health care clinic settings, the VA system has successfully decreased its rate of benzodiazepine prescriptions in older veterans since 2013.
At the time of this study, there were 24,512 veterans, 75 years old and older, who were receiving long-term benzodiazepine treatment. All facilities that were interviewed, regardless of performance, employed passive strategies primarily consisting of education about appropriate prescribing, alternatives to prescribing benzodiazepines, and identifying potential patients for discontinuation. However, high-performing facilities described leveraging one or more active strategies including providing prescribing guidance for clinicians, administrative restrictions on benzodiazepine prescriptions, and performance measures to incentivize clinicians to lower prescriptions rates for benzodiazepines.
The researchers concluded that initiatives that are primarily limited to passive strategies, such as education and patient identification, may have limited success in lower prescription rates for older adults. They also suggest clinicians might benefit from additional recommendations, support, and incentives to modify prescribing practices.
Maust, D.T., et al. (2022) Strategies associated with reducing benzodiazepine prescribing to older adults: A mixed methods study. The Annals of Family Medicine. doi.org/10.1370/afm.2825.