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Inadequate prescription of benzodiazepines in primary health care and its consequences: PRESCRIBZD study

Abstract

The management of anxiety and sleep disorders may require the use of benzodiazepines (BZD). However, the prolonged or inappropriate use of these drugs exposes the individual to potential adverse effects, such as cognitive decline, mental confusion, impaired memory and attention, dependence, tolerance, increased risk of falls and respiratory dysfunction. Aim. To investigate the pattern of use and factors associated with inadequate prescription of BZD dispensed in Primary Health Care (PHC) in the city of Ribeirão Preto and propose a protocol to minimize such inadequacies. Method. Analytical cross-sectional study conducted in the PHC of Ribeirão Preto, SP. In Stage 1 of the research, all records of dispensing BZD drugs from public pharmacies in the city between the years 2018 and 2022 will be considered to estimate BZD consumption, using the metrics Prescribed Daily Dose and Defined Daily Dose per 1,000 inhabitants/ day, which will be compared with the WHO Defined Daily Dose values. The prevalence and risk factors (such as exposure to polypharmacy, age or gender) that predispose to prolonged use of BZD and prescription for the elderly will also be determined, in addition to the prevalence of clinically relevant drug interactions involving BZD. Stage 2 of the research will be conducted with 139 individuals using BZD for more than 3 months, who will answer a sociodemographic and clinical questionnaire and instruments to assess the severity of dependence (Benzodiazepine Dependence - Self Report Questionnaire), cognitive function (Mini- Mental State Examination), sleep quality (Insomnia Severity Index), anxiety (Beck Anxiety Inventory) and depression (Beck Depression Inventory). In stage 3 of the research, a BZD deprescription protocol for anxiety disorders and insomnia in the PHC will be elaborated and validated by consensus of specialist physicians who work in the city's PHC (Delphi technique). (AU)

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