Rationale of Benzodiazepines Prescription among type 2 diabetes patients attending the primary care unit of a university hospital in Thailand

Abstract

Background: Benzodiazepine prescriptions by physicians are the most common found in patients with mental health disorders. Most of the mental health problems presenting in organic disease patients including diabetes were insomnia, anxiety and depression, leading to the increasing of benzodiazepine (BDZ) prescriptions by physicians to treat these symptoms. However, there few studies on the rationale of benzodiazepines prescriptions among type 2 diabetes patients attending the primary care unit of a university hospital in Thailand.

Objectives: To describe the rate of BDZ prescription and rationale of BDZ prescription and to determine factors associated with BDZ prescriptions.

Methods: Retrospective descriptive study were conducted among 847 DM type 2 patients visiting the primary care unit of a university hospital in year 2017. Data were obtained from the hospital information system (HIS) including patients’ demographic data, medication information, details and reasons of BDZ prescription by physicians. The data were analyzed by descriptive statistics, Chi-squared test, Independent sample T-test and Mann-Whitney U-test.

Results: The rate of BDZ prescription was 9.2 % of type 2 diabetes patients attending the primary care unit. The appropriate rationale (indication, dose and duration) of BDZ prescription was 23.5%. The inappropriate of all issues of rationale of BDZ prescription was 4.3%. The most appropriate issue was the rationale of dose (96.9%). The least appropriate issue was the rationale of duration (24.1%). Factors associated with BDZ prescription were patients occupation (P = 0.017). The statically significant factor with the rationale of BDZ prescription was age (P = 0.004). The most inappropriate of BDZ prescription found in elderly patients.

Conclusion: BDZ were mostly prescribed in DM type 2 elderly patients. The most appropriate issue was the rationale of dose but there were a few problems in the rationale of duration. This study might be benefit for physicians in the decision and managementof BDZ prescription regarding to the standard guideline of drug prescription for prevention patients of the overuse, dependency and BDZ abuse.