Prescribing practices of Benzodiazepines and related medicines in a General Practice Clinic in Southern Nigeria

Abstract

Background: Benzodiazepines and benzodiazepine receptor agonists (Z-drugs) are commonly used to manage anxiety and sleep disorders but are associated with risks of dependence and inappropriate use. Evidence from general practice settings in Nigeria remains sparse despite global concerns about their misuse. The aim of this study was to evaluate the extent of use and the prescription pattern of these medicines in a Nigerian general practice clinic.

Methods: A retrospective cross-sectional study was conducted using pharmacy sales and case records from the General Practice Clinic of a tertiary hospital in Nigeria, from January to December 2021. All prescriptions containing benzodiazepines or Z-drugs were identified. Demographic, clinical, and prescription details were extracted and analyzed using descriptive statistics with SPSS version 21.

Results: Of 25,258 prescriptions, 825(3.3%) contained benzodiazepines or Z- drugs. The mean age was 52.1 ± 16.8 years with more females 602 (73%). Hypertension comorbidity was present in 467 (56.6%). The most prescribed medications were bromazepam 323 (39.2%), nitrazepam 191 (23.2%), and zopiclone 157 (19.0%). Insomnia 365 (44.2%), hypertension 167 (20.2%), and anxiety 159 (18.7%) were the leading diagnoses. The mean duration (SD) of benzodiazepine prescriptions was 5 (3 days). Zopiclone was prescribed for longer periods (SD) of 8.6 (3.7) days and to older persons with a mean age of 56.7 (14.5) years. Previous use was documented in 169 (20.5%) patients.

Conclusion: Although benzodiazepines and Z-drugs were often prescribed for short durations, their use in patients with comorbid hypertension and history of prior use raises concerns about potential inappropriate prescribing and requires intervention.