Racionalnost uporabe benzodiazepina i potreba za depreskripcijom u osoba starije životne dobi: presječno istraživanje u domovima za starije i nemoćne osobe

master's thesis

• Title (english): Rational use of benzodiazepines and the need for deprescribing in older adults: cross-sectional study in nursing homes
• Author: Matea Pavičić
• Mentor: Maja Ortner Hadžiabdić (mentor)
• Committee member: Maja Ortner Hadžiabdić (predsjednik povjerenstva)
• Committee member: Lidija Bach-Rojecky (član povjerenstva)
• Committee member: Laura Nižić Nodilo (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Centre for applied pharmacy); Zagreb
• Defense date and country: 2023-07-11, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Benzodiazepini su jedna od najpropisivanijih skupina lijekova te im potrošnja kontinuirano raste. Njihova
dugotrajna primjena se ne preporučuje zbog niza nuspojava koje mogu uzrokovati, no unatoč tome, predugo
korištenje benzodiazepina je čest terapijski problem. Posebno osjetljiva skupina su osobe starije životne
dobi kojima se ova skupina lijekova izrazito često propisuje te se sve više javlja potreba za racionalizacijom
terapije i potencijalnom depreskripcijom. Depreskripcija je proces ukidanja neprikladnog lijeka iz terapije
(ili smanjenje doze) s ciljem najboljeg terapijskog ishoda za pacijenta, uz nadziranje procesa od strane
zdravstvenih djelatnika. Cilj je ovog istraživanja bio utvrditi racionalnost primjene benzodiazepina u osoba
starije životne dobi koje su korisnici domova za starije i nemoćne te identificirati pacijente koji bi mogli
imati korist od depreskripcije. U istraživanje su bili uključeni korisnici domova za starije i nemoćne osobe
na području Dalmacije, Slavonije i Grada Zagreba, stariji od 65 godina, a podatci su prikupljeni pomoću
standardiziranog interRAI upitnika, alata za sveobuhvatnu gerijatrijsku procjenu. Na temelju smjernica za
depreskripciju benzodiazepina, za potrebe istraživanja definirana su četiri kriterija prema kojima se
određivala potreba za depreskripcijom. Uključeno je 225 ispitanika, prosječne dobi 82,52 ± 6,223 (40,4%
duboke starosti (>85 godina)), od kojih su 76,5% činile žene. Utvrđeno je da 127 ispitanika u terapiji ima
benzodiazepin, a njih 106 (83,5%) bili bi potencijalni kandidati za depreskripciju. Najčešće zadovoljen
kriterij za depreskripciju bio je preduga primjena terapije (duže od 12 tjedana), prisutna kod 59,8%
ispitanika. Rezultati dobiveni ovim istraživanjem ukazuju na potrebu za racionalnijom primjenom
benzodiazepina te na značajan udio ispitanika u domovima za starije i nemoćne koji bi mogli imati koristi
od depreskripcije ove skupine lijekova.

Abstract (english)

Benzodiazepines are among the most commonly prescribed drug classes, and their consumption is steadily
increasing. However, their long-term use is not recommended due to the various side effects they can cause.
Consequently, prolonged benzodiazepine use poses a common therapeutic problem. Older individuals are
particularly susceptible to the effects of benzodiazepines, but healthcare professionals frequently prescribe
this class of drugs to them. Hence, there is a growing need to rationalize therapy and potentially reduce
benzodiazepine usage. Deprescribing refers to the process of discontinuing inappropriate medication or
reducing the dosage with the goal of achieving the best therapeutic outcome for the patient, under the
supervision of healthcare professionals. The objective of this study was to assess the appropriateness of
benzodiazepine use in older individuals residing in nursing homes and to identify patients who could
benefit from deprescription. This study involved residents of nursing homes in the regions of Dalmatia,
Slavonia, and the City of Zagreb, aged 65 years and above. Data was collected using a standardized
interRAI questionnaire designed for comprechensive geriatric assessment in long-term care facilities. Based
on deprescription guidelines for benzodiazepines, four criteria were defined for the purpose of this research
to determine the need for deprescription. The participants' mean age was 82.52 ± 6.223 years, with 40.4%
classified as very old (>85 years), and 76.5% were female. The study found that 127 participants were using
benzodiazepines in their therapy, and among them, 106 (83.5%) would be potential candidates for
deprescription. The most frequently identified reason for deprescription was prolonged therapy (use for
more than 12 weeks), which was observed in 59.8% of participants. The results obtained from this study
highlight the necessity for a more rational use of benzodiazepines and reveal a significant percentage of
nursing home residents who could benefit from the deprescription of benzodiazepines.

• Keywords: benzodiazepini; depreskripcija; starija životna dob
• Keywords (english): benzodiazepines; deprescription; older adults
• Language: croatian
• URN:NBN: urn:nbn:hr:163:361954
• Study programme: Title: Pharmacy; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: magistar/magistra farmacije (magistar/magistra farmacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-11-08 09:44:49