Rational prescription of benzodiazepines in primary care: are we on the right track?

Description

It is estimated that around 20% of primary care consultations are related to mental health problems, which, together with the high demand for care, make doctors in primary care vulnerable to the prescription of drugs such as benzodiazepines (BDZ). The objective of the study was to contribute to the correct use of BZD in the San Alberto Hurtado CESFAM, through a description of the prescriptions emitted, identification of the factors that influence the indication and description of the best available evidence for the rational prescription, with emphasis on depressive disorders, panic disorders and insomnia. Statistical data was collected from the medical prescriptions emitted. In addition, a modified survey was applied to the doctors about the factors that influence the prescription of BDZ and possible actions to diminish it. Among the findings, there is an annual 2% of all the prescriptions emitted were for BZD, with an average patient age of 46, 7 years. 20.3% correspond to prescriptions emitted to people over 60 years. Clonazepam was the BZD most prescribed (86%). 24.2% of the prescriptions were emitted for more than 3 months. From the survey, most doctors recognize that the most influential factor for prescripting BZD was the decrease in the threshold of tolerance of the population to emotional distress caused by the problems of daily life, resulting in a "medicalization " of life and consider that the most important action to reduce the prescription of BZD is to train doctors about good prescribing habits and how not to medicalize problems of daily life. Considering  the adverse effects of this type of medication, BZD should not be prescribed for more than 4 weeks for the conditions stduied, and should not be prescribed for insomnia. Sending personalized letters to the patient with prolonged consumption is an encouraging strategy.