Study Reveals Concerning Trend in Sedative Prescriptions for Older Stroke Survivors

A recent study published in Stroke, the American Stroke Association's scientific journal, has uncovered a worrying pattern in the prescription of benzodiazepines to older stroke survivors. The research, which analyzed Medicare claims data for over 120,000 patients aged 65 and older who were hospitalized for ischemic stroke, found that approximately 5% received their first prescription for benzodiazepines within 90 days of their stroke.

Of particular concern is the quantity of medication being prescribed. More than half of these initial prescriptions were for a 15 to 30-day supply, far exceeding the recommended short-term, as-needed use for this vulnerable population. This oversupply raises the risk of dependence, falls, and other adverse effects that could impede recovery and rehabilitation.

The study also revealed disparities in prescription patterns. Women were more likely than men to receive benzodiazepine prescriptions post-stroke, and prescription rates were highest in the Southeast region of the United States. While there has been a modest nationwide decline in initial prescriptions from 2013 to 2021, the current rate remains a significant concern for healthcare professionals.

Julianne Brooks, M.P.H., a co-author of the study, emphasized the critical nature of the first 90 days post-stroke for rehabilitation. She noted that benzodiazepines might inhibit recovery and rehabilitation during this crucial period. The findings underscore the need for increased awareness among healthcare providers about the risks associated with prescribing these medications to older stroke survivors.

This research highlights the importance of adhering to guidelines such as the American Geriatrics Society Beers Criteria, which recommends avoiding benzodiazepines in all older adults due to the risk of cognitive impairment, falls, and other adverse outcomes. The study's authors suggest that alternative interventions, such as cognitive behavioral therapy for insomnia and non-pharmaceutical approaches, should be considered before resorting to benzodiazepines.

As stroke remains a leading cause of long-term disability in the United States, these findings have significant implications for post-stroke care and patient outcomes. The study calls for further research to determine safe prescription levels for older adults and emphasizes the need for improved guidelines to ensure the best possible care for stroke survivors.