TY - JOUR

T1 - Continuity of treatment with benzodiazepines in dementia patients

T2 - An analysis of German health insurance claims data

AU - Hessmann, Philipp

AU - Zeidler, Jan

AU - Neubauer, Sarah

AU - Abdel-Hamid, Mona

AU - Stahmeyer, Jona

AU - Eberhard, Sveja

AU - Wolff-Menzler, Claus

AU - Wiltfang, Jens

AU - Kis, Bernhard

N1 - Funding information: Philipp Hessmann was financially supported by a scholarship from the Research School for Translational Medicine at the University Medical Center in Goettingen (Göttinger Kolleg für Translationale Medizin), which was funded by the Lower Saxony Ministry of Science and Culture (Niedersächsisches Ministerium für Wissenschaft und Kultur). Professor Dr Jens Wiltfang is supported by an Ilídio Pinho professorship and iBiMED (UID/BIM/04501/2013), at the University of Alveiro, Portugal. All remaining authors certify that they have no affiliations with or involvement in any organization or entity with any financial or nonfinancial interest in the subject matter or materials discussed in this manuscript. Anonymized data were provided by the AOK Niedersachsen. The authors would like to thank all colleagues at the CHERH assisting with the data analysis. Especially, the authors would like to thank the Research School for Translational Medicine at the University Medical Center in Goettingen (Göttinger Kolleg für Translationale Medizin) and the Lower Saxony Ministry of Science and Culture (Niedersächsisches Ministerium für Wissenschaft und Kultur) for supporting this research project.

PY - 2018/9/1

Y1 - 2018/9/1

N2 - Long-term treatment with benzodiazepines (BZD) should be avoided in dementia patients because of an increased risk of adverse events. We evaluated how continuously dementia patients were prescribed BZD over 12 months. For this observational study, we used claims data from a large German public sickness fund for 2014 and 2015, including patients with an incident diagnosis of dementia in 2014. The aim was to evaluate the continuity of treatment, the frequency of BZD prescriptions and defined daily doses were evaluated. In total, 1298 (5.6%) patients received 4.7± 5.2 BZD prescriptions in 2015 on average. Thereof, lorazepam (47.5%), oxazepam (18.6%), diazepam (14.5%), and bromazepam (12.2%) were most often prescribed. 30.7% of the patients received at least one BZD prescription in each quarter of 2015. Although the total number of patients receiving BZD decreased in 2015, defined daily doses for single substances remained mainly unchanged. The incident diagnosis of dementia was not associated with modifications of prescription behavior. The treatment with BZD was not discontinued in a large proportion of dementia patients, increasing the risk of adverse events. Physicians' awareness of avoiding BZD should be improved and further evidence for the appropriate treatment of psychiatric symptoms in dementia (e.g. sleep disturbances, anxiety) is required.

AB - Long-term treatment with benzodiazepines (BZD) should be avoided in dementia patients because of an increased risk of adverse events. We evaluated how continuously dementia patients were prescribed BZD over 12 months. For this observational study, we used claims data from a large German public sickness fund for 2014 and 2015, including patients with an incident diagnosis of dementia in 2014. The aim was to evaluate the continuity of treatment, the frequency of BZD prescriptions and defined daily doses were evaluated. In total, 1298 (5.6%) patients received 4.7± 5.2 BZD prescriptions in 2015 on average. Thereof, lorazepam (47.5%), oxazepam (18.6%), diazepam (14.5%), and bromazepam (12.2%) were most often prescribed. 30.7% of the patients received at least one BZD prescription in each quarter of 2015. Although the total number of patients receiving BZD decreased in 2015, defined daily doses for single substances remained mainly unchanged. The incident diagnosis of dementia was not associated with modifications of prescription behavior. The treatment with BZD was not discontinued in a large proportion of dementia patients, increasing the risk of adverse events. Physicians' awareness of avoiding BZD should be improved and further evidence for the appropriate treatment of psychiatric symptoms in dementia (e.g. sleep disturbances, anxiety) is required.

KW - benzodiazepines

KW - claims data

KW - continuity

KW - dementia

KW - pharmacotherapy

KW - prescription patterns

UR - http://www.scopus.com/inward/record.url?scp=85051242152&partnerID=8YFLogxK

U2 - 10.1097/YIC.0000000000000230

DO - 10.1097/YIC.0000000000000230

M3 - Article

C2 - 29952800

AN - SCOPUS:85051242152

VL - 33

SP - 282

EP - 289

JO - International Clinical Psychopharmacology

JF - International Clinical Psychopharmacology

SN - 0268-1315

IS - 5

ER -