The Cascade Of Benzodiazepine Prescribing For Hospitalized Geriatric Patients

Background: Hospitalists increasingly provide care for geriatric patients and little is known about the extent to which hospitalists adhere to evidence-based medication guidelines. This study aimed to characterize hospitalist adherence to BEERS guidelines for prescribing and monitoring benzodiazepines for older adults.Methods: We conducted a retrospective chart review of admitted patients aged 70-85 years who had been prescribed benzodiazepine. Charts from 351 patients were analyzed for documentation and decision rationale, which included 638 separate notes.Results: Benzodiazepines were prescribed 28.2% of the time to address anxiety, which is inconsistent with the BEERS criteria; 39% had adequate data in the impression and plan section of the note to reflect why benzodiazepine was prescribed. Of note, the majority of notes had partial or missing data.Conclusion: Physicians tended to follow guidelines more than advance practice providers. Wide variation persists in prescribing practices and documentation related to benzodiazepines and both could potentially be addressed with further training.