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Wijeyakuhan N, Gruber R, Rattray NA. The cascade of benzodiazepine prescribing for hospitalized geriatric patients. Journal of Community Hospital Internal Medicine Perspectives. 2020 Oct 29; 10(6):542-545.
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.