General practitioners’ prescriptions of benzodiazepines, Z-hypnotics and opioid analgesics for elderly patients during direct and indirect contacts. A cross-sectional, observational study
Open accessAbstract
OBJECTIVE: To describe Norwegian general practitioners' (GPs') prescription patterns of benzodiazepines, Z-hypnotics and opioid analgesics (BZO-drugs) to elderly (≥70 years) patients. DESIGN, SUBJECTS AND SETTING: Cross sectional, observational study. Contact- and prescription data from 148 Norwegian GPs, issued for elderly patients during eight months in 2008. GP-patient contacts were categorized as direct contacts (DC: face-to-face consultations) or indirect contacts (IC: via third party, phone or mail). Explanatory variables were characteristics linked to the GPs, patients, and practices. During analyses, GPs' number of listed patients, share of which for elderly patients, and total number of patient consultations during the period (proxy for practice activity), were categorized in quintiles (Q1-5) by number of GPs. MAIN OUTCOME MEASURES: Number of BZO-drug prescriptions and quantities issued during direct- and indirect GP-patient contacts. RESULTS: In total, 62% of BZO-prescriptions were issued during ICs. Of all prescriptions, 66% were large quantum packages (50 tablets or more), 62% out of which were prescribed during ICs. During the study period, 50% of the patients received repeat prescriptions. Prescribing during ICs was associated with low over all practice activity (Q1) and many (Q5) older patients on the GP's lists. CONCLUSION: GPs' BZO-drug prescribing to elderly occur more frequently during ICs than within DCs, and are more commonly issued as large quantity packages. This indicates that regular- or long-term use among elderly is common, contrasting with previous and current national guidelines, which recommend regular clinical assessments and short time or intermittent use of BZO-drugs. Key Points GPs frequently prescribe benzodiazepines, Z-hypnotics and opioid (BZO) drugs for elderly people. BZO-drugs are frequently issued during indirect GP-patient contacts and in relatively large quantities, indicating regular or long-term use. GPs' BZO-drug prescribing patterns contrast with national guidelines recommending clinical assessment and short time or intermittent use of BZO-drugs.
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Primary care professionals are more likely to prescribe medications in remote consultations than in face-to-face settings.
“For example, PCPs are more likely to prescribe medications in remote consultations than in face-to-face settings [6,7].”
From Impact of Remote Consultations on Antibiotic Prescribing in Primary Health Care: Systematic Review (2020) · cites this paper as [7]
CNSDs were frequently prescribed by GPs in large quantities and through indirect contacts without consultation.
“another study found that CNSDs were frequently prescribed by GPs in large quantities and through indirect contacts without consultation.6”
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- Authors
- Sundseth, A. C., Gjelstad, S., Straand, J., & Rosvold, E. O.
- Affiliations
- University of Oslo (NO)
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway;
- Corresponding author
- Sundseth, Anne Cathrine
- ORCID
- Rosvold, Elin O.
- Venue
- Scandinavian Journal of Primary Health Care
- Publisher
- Informa UK Limited
- Published
- 2018-04-03
- Volume
- 36
- Issue
- 2
- Pages
- 115-122
- ISSN
- 0281-3432 (ISSN-L)
- 1502-7724
- PMC
- PMC6066290
- OpenAlex
- W2796638663
- Cited by
- 19
- References
- 26
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 6 · 2021: 2 · 2020: 2 · 2019: 4
- FWCI
- 1.11
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Scandinavian Journal of Primary Health Care (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by-nc)
- Funders
- The Norwegian Research Fund for General Practice (AMFF)
- Gidske and Peter Jacob Sørensen Fund
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- benzodiazepines, Z-drugs, opioid analgesics, elderly patients, general practitioners, prescribing patterns, repeat prescriptions, long-term drug use, guideline adherence, primary care prescribing
- MeSH terms
- Aged, Aged, 80 and over, Analgesics, Opioid, Benzodiazepines, Cross-Sectional Studies, Drug Utilization, Female, Health Services for the Aged, Humans, Hypnotics and Sedatives, Male, Norway, Physician-Patient Relations, Practice Patterns, Physicians', Drug Prescriptions, Referral and Consultation, Guideline Adherence, General Practitioners, General Practice
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