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February 1990

Effects of Patient Age and Physician Training on Choice and Dose of Benzodiazepine Hypnotic Drugs

Author Affiliations

From the Division of Geriatric Medicine, Department of Medicine, University Hospitals of Cleveland (Ohio) and Case Western Reserve University School of Medicine, Cleveland, Ohio (Dr Shorr); and the College of Pharmacy, University of Wisconsin, Madison (Dr Bauwens). Dr Bauwens is now with LTC Pharmacy Management, South Bend, Ind.

Arch Intern Med. 1990;150(2):293-295. doi:10.1001/archinte.1990.00390140047010

• We conducted a cross-sectional review of all prescriptions (N = 554) for triazolam and flurazepam hydrochloride written by nonpsychiatrists to outpatients at a university affiliated Veterans Administration hospital. We sought to determine whether triazolam, an agent with a short half-life, was used preferentially in older patients (age ≥70 years). We also wanted to determine whether dosages of triazolam or flurazepam were lowered in elderly patients. Our findings showed that prescriber level of training was a much stronger determinant of drug choice than patient age. Attending physicians prescribed flurazepam twice as often as interns. Lower dosages of both agents were prescribed more frequently to older patients. Our data suggest that some physicians choose a benzodiazepine hypnotic out of habit rather than application of pharmacologic principles, but reduce doses appropriately when prescribing to elderly patients.

(Arch Intern Med. 1990;150:293-295)

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