1. Prevalence of BZD & Other Respiratory Depressing Agents, n=58.
Characterizing Benzodiazepine Prescribing in Ambulatory Palliative Care Patients Living with Cancer
Courtney Cobert, Amy Dunleavy, Tiffany Khachikian, Meghal Patel & Kashelle Lockman, PharmD, MA
Introduction
Results
Conclusions
BZD are commonly prescribed in PC for indications with limited data for efficacy beyond short-term use
PC patients may be at increased risk for:
falls, fractures, and cognitive impairment due to prevalent BZD prescribing
respiratory depression due to frequent concomitant BZD, opioid, & gabapentinoid prescribing
2013: Benzodiazepine (BZD) prescriptions increased 67% over a 17 year period
Since 2013: BZD were implicated in 30% of all overdose fatalities
2016: FDA issued a black box regarding the dangers of concomitant BZD and opioid use
PC appointment 1/2017 – 6/2017
≥ 18 years old
n = 114
No Cancer
n = 21
No BZD
n = 35
Cancer Diagnosis
n = 93
Prescribed ≥ 1 BZD
n = 58
97%
Objectives
Anxiety
55%
of patients prescribed
Determine the prevalence of & indications for BZD prescribing in patients living with cancer receiving palliative care (PC) services
Determine concomitant use of medications that interact with BZDs to increase risk of respiratory depression
Limitations
BZDs for
Procedures
26%
Small sample size
Actual vs. prescribed BZD use indeterminable from retrospective chart review
anxiety or
sleep
Sleep
10%
were also prescribed an
opioid
Future Opportunities
Prevalence of BZD & Other Respiratory Depressing Agents, n=58
Identify prescribers initiating BZD therapy for anxiety & sleep
Evaluate chronic BZD use/indications
Educate prescribers & patients on BZD risk and interactions
Methods
Muscle relaxant
Retrospective chart review:
Demographics
BZD prescribed & indication
Concomitant respiratory depressant prescribed
Sedative hypnotic
Gabapentinoid
Opioid
References
Bachhuber M, et al. American Journal of Public Health 2016