The use of benzodiazepines has been associated with several adverse effects
including, ataxia, dizziness, over-sedation, anterograde amnesia, and dependence.
The severity of adverse effects, particularly those associated with the central
nervous system, may be greater in older adults. Therefore, close monitoring is
typically recommended when benzodiazepines are used by older adults. In addition,
several reviews and guidelines recommend that the use of long-acting benzodiazepines
by older adults be avoided. High utilization by older adults and documented safety
concerns indicate that a review of the evidence on the use of benzodiazepines by
older adults is warranted.
Health technology assessment agencies face the challenge of providing
quality assessments of medical technologies in a timely manner to support
decision-making. Ideally, all important deliberations would be supported by
comprehensive health technology assessment reports, but the urgency of some
decisions often requires a more immediate response.
The Health Technology Inquiry Service (HTIS) provides Canadian health
care decision-makers with health technology assessment information, based on the
best available evidence, in a quick and efficient manner. Inquiries related to
the assessment of health care technologies (drugs, devices, diagnostic tests,
and surgical procedures) are accepted by the service. Information provided by
HTIS is tailored to meet the needs of decision-makers, taking into account the
urgency, importance, and potential impact of the request.
Consultations with the requestor of this HTIS assessment indicated that a
review of the literature would be beneficial. The research question and
selection criteria were developed in consultation with the requestor. The
literature search was carried out by an information specialist using a
standardized search strategy. The review of evidence was conducted by one
internal HTIS reviewer. The draft report was internally reviewed and externally
peer-reviewed by two or more peer reviewers. All comments were reviewed
internally to ensure that they were addressed appropriately.
CADTH is funded by Canadian federal,
provincial, and territorial governments.
Suggested citation:
McIntosh B, Clark M, Spry C.
Benzodiazepines in Older Adults: A Review of Clinical Effectiveness,
Cost-Effectiveness, and Guidelines [Internet]. Ottawa: Canadian
Agency for Drugs and Technologies in Health; 2011 (Rapid Response Report:
Peer-Reviewed Summary with Critical Appraisal). [cited 2011-01-06]. Available
from: http://www.cadth.ca/index.php/en/hta/reports-publications/search/publication/2773.
Production of this report is made possible by financial contributions from
Health Canada and the governments of Alberta, British Columbia, Manitoba, New
Brunswick, Newfoundland and Labrador, Northwest Territories, Nova Scotia, Nunavut,
Prince Edward Island, Saskatchewan, and Yukon. The Canadian Agency for Drugs and
Technologies in Health takes sole responsibility for the final form and content of
this report. The views expressed herein do not necessarily represent the views of
Health Canada, or any provincial or territorial government.
This document is prepared by the Health Technology Inquiry Service (HTIS), an
information service of the Canadian Agency for Drugs and Technologies in Health
(CADTH). The service is provided to those involved in planning and providing health
care in Canada. HTIS responses are based on a comprehensive and systematic search of
literature available to CADTH at the time of preparation. The intent is to provide a
summary and critical appraisal of the best evidence on the topic that CADTH could
identify using all reasonable efforts within the time allowed. This response has
been peer-reviewed by clinical experts. The information in this document is intended
to help Canadian health care decision-makers make well-informed decisions and
thereby improve the quality of health care services. HTIS responses should be
considered along with other types of information and health care considerations.
This report should not be used as a substitute for the application of clinical
judgment in respect of the care of a particular patient or other professional
judgment in any decision-making process, or as a substitute for professional medical
advice. Readers are also cautioned that a lack of good-quality evidence does not
necessarily mean a lack of effectiveness, particularly in the case of new and
emerging health technologies for which little information can be found, but which
may in the future prove to be effective. While CADTH has taken care in the
preparation of this document to ensure that its contents are accurate, complete, and
up to date as of the date of publication, CADTH does not make any guarantee to that
effect. CADTH does not guarantee and is not responsible for the quality, currency,
propriety, accuracy, or reasonableness of any statements, information, or
conclusions contained in the source documentation. CADTH is not responsible for any
errors or omissions or injury, loss, or damage arising from or relating to the use
(or misuse) of any information, statements, or conclusions contained in or implied
by the information in this document or in any of the source documentation.