title: Benzodiazepine Prescribing in Older Adults in U.S. Ambulatory Clinics and Emergency Departments (2001-10).
abstract: OBJECTIVE
  To assess trends in benzodiazepine use from 2001 to 2010 in older adults in U.S. ambulatory clinics and emergency departments (EDs).
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  2001 to 2010 National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS).
  
  
  METHODS
  Individuals aged 65 and older for whom the reason for visit might prompt a physician to use a benzodiazepine (e.g., anxiety, detoxification, back sprain).
  
  
  METHODS
  The NAMCS and NHAMCS were used to evaluate U.S. ambulatory clinic and ED visits. Encounters involving individuals aged 65 and older for whom a benzodiazepine might be prescribed were analyzed. Trends in benzodiazepine use in these visits were explored, and predictors of use were assessed using survey-weighted chi-square tests and logistic regression.
  
  
  RESULTS
  From 2001 to 2010, benzodiazepines were used in 16.6 million of 133.3 million ambulatory clinic visits and 1.9 million of 18.1 million ED visits with the selected reasons for the visits. There was no change in benzodiazepine use in either setting over the study period, although benzodiazepine use for those aged 85 and older increased from 8.9% to 19.3% in ambulatory clinics and 10.1% to 17.2% in EDs. Individuals visiting clinics with anxiety were five times as likely to receive benzodiazepines (odds ratio (OR) = 4.8), and those in EDs were twice as likely (OR = 2.3).
  
  
  CONCLUSIONS
  Despite safety concerns, benzodiazepine use in older adults in U.S. ambulatory clinics and EDs did not change from 2001 to 2010. In the oldest individuals, who are at higher risk of adverse events, a greater increase was seen than in those aged 65 to 84. Additional measures may be needed to promote alternatives to benzodiazepines.
authors.affiliation: Department of Emergency Medicine, Long Island Jewish Medical Center, New Hyde Park, New York.
authors.forename: Erin M
authors.initials: EM
authors.lastname: Marra
authors.affiliation: Department of Emergency Medicine, MedStar Washington Hospital Center, Washington, District of Columbia.
authors.forename: Maryann
authors.initials: M
authors.lastname: Mazer-Amirshahi
authors.affiliation: School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia.
authors.forename: Gillian
authors.initials: G
authors.lastname: Brooks
authors.affiliation: Department of Pediatrics, George Washington University, Washington, District of Columbia.|Department of Clinical Pharmacology, Children's National Medical Center, Washington, District of Columbia.|Intensive Care, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands.|Department of Paediatric Pharmacology, University Children's Hospital Basel, Basel, Switzerland.
authors.forename: John
authors.initials: J
authors.lastname: van den Anker
authors.affiliation: Department of Emergency Medicine, George Washington University, Washington, District of Columbia.
authors.forename: Larissa
authors.initials: L
authors.lastname: May
authors.affiliation: Department of Emergency Medicine, George Washington University, Washington, District of Columbia.
authors.forename: Jesse M
authors.initials: JM
authors.lastname: Pines
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D001007:Anxiety / Q000188:drug therapy / Q000453:epidemiology; D001569:Benzodiazepines / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data* / Q000639:trends; D004636:Emergency Service, Hospital; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D012189:Retrospective Studies; D012737:Sex Factors; D012893:Sleep Wake Disorders / Q000188:drug therapy; D014481:United States / Q000453:epidemiology
chemical_list: D001569:Benzodiazepines
keywords: ambulatory clinic; benzodiazepines; emergency department; older adults