Prevalência e fatores associados ao uso de benzodiazepínicos por idosos atendidos na atenção primária à saúde

Abstract

Aging is accompanied by changes in the body, including loss of postural tone and weakening of the bones, which facilitate falls and fractures. The use of benzodiazepines (BZD) is an aggravating factor, and therefore it is part of the Beers criteria as an inappropriate medication for the elderly. The objective of this study was to analyze the prevalence of the use of BZD drugs and their distribution according to sociodemographic, behavioral and health characteristics of the elderly population in a municipality in the north of Rio Grande do Sul. This is a cross-sectional study, carried out with elderly people (≥ 60 years), followed up in Primary Health Care in Marau, RS. The sample consisted of those who performed at least one medical and/or nursing consultation in 2019, data were collected online from electronic medical records and the study was approved by the Ethics Committee in Research with Human Beings from UFFS (opinion No. 4,769,903). The analysis included sample characterization, calculation of the prevalence of BZD use with an interval of 95% (95%CI), verification of its distribution according to independent variables (5% chi-square), and description of the frequency of BZD representatives. In the sample of 1,728 elderly people, there was a predominance of women (60.1%), aged between 60-69 years (57.1%), white skin color (77.3%), incomplete elementary school (85%) and who did not have a paid activity (87.1%). In addition, 3.8% of the sample had some kidney disease, 19.5% some mental disorder, 4.2% anxiety and 0.6% insomnia. The prevalence of BZD use was 12% (95%CI 11-14), higher in females (13.9%; p=0.011), among those with kidney disease (23%; p=0.009), with mental disorders (24.6%; p<0.001), with anxiety (31.9%; p<0.001) and insomnia (54.5%; p<0.001). Clonazepam was the most used drug (40.5%), followed by diazepam (31.6%). This study showed similarity with the prevalence of BZD use by the elderly in the southern region of the country and lower compared to a previous study in the same municipality, in addition to bringing theoretical novelties regarding kidney disease. It is important to remember that the chronic use of BZD is linked to falls in the elderly, one of the major causes of morbidity and mortality in this population, and cognitive deficit, which is severely contraindicated by the Beers criteria. Among the BZD options, clonazepam and diazepam were the most prevalent, being less safe options for the elderly.