Medicare Part D's Exclusion of Benzodiazepines and Fracture Risk in Nursing Homes

Abstract

Controversy continues to surround the safety of benzodiazepine use in nursing homes (NHs), even though as many as 30% of residents receive these agents.¹ Benzodiazepine medications have well-documented sedative effects that can impair cognition and balance and produce daytime somnolence.² Benzodiazepines have also been associated with an increased risk of falls and fractures in NHs, although the findings are inconsistent.^3-6 In addition, abrupt discontinuation of benzodiazepine use, especially after long-term use, has been associated with confusion, elevated systolic blood pressure, and, in rare cases, seizures.^7-9 However, no data have indicated that policies to limit benzodiazepine use in older, institutionalized adults result in reduced risk of falls and injury.^7,10