Analysis of the Benzodiazepine prescribing patterns in the primary healthcare of the Republic of Srpska

Background: Benzodiazepines (BZDs) are very often inappropriately prescribed drugs. The aim of this study is to analyse physicians' prescribing patterns for BZD in Republic of Srpska, and to assess to what extent primary diagnosis determine the dose and the length of use of BZDs. Methods: A retrospective analysis of the physicians' prescription habits based on the database of Family Medicine Information Systems of Republic of Srpska, as well as on data from patient’s medical record were performed. Patients’ socio-demographic and clinical characteristics, including the data on the type and dose of BZDs prescribed, were recorded and evaluated. Results: BZDs were mostly prescribed for anxiety disorders (30.05%), for depressive disorders (17.54%), and for anxiety-depressive disorders (10.86%). A significant amount of BZDs was prescribed for non-psychiatric diagnoses (23.81%). Patients suffering from psychotic disorders were taking the highest dose of BZD and for the longest periods of time (p<0.001). Longer use of BZDs was in women (r=0.04, p<0.001), elderly (r=0.178, p<0.001), single people (r=0.12, p<0.001), those who live in urban areas (r=0.45, p<0.001) and those who were prescribed higher doses (r=0.213, p<0.001). Conclusion: A significant percentage of patients were using the BZDs for longer period of time than recommended. Strongest positive correlation was found between the dose and the length of use, which implies the addictive potential of BZDs. Since it has been noticed that prolonged use, or abuse is present regardless of the diagnosis, precaution is advised when prescribing BZDs even for acute diseases.