Variation in benzodiazepine and antipsychotic use in people aged 65 years and over in New Zealand.

AIMS: To examine the variation in the dispensing of antipsychotic and benzodiazepine medicines in the elderly (aged 65+) across New Zealand. METHODS: Data drawn from the New Zealand Pharmaceutical Collection for the New Zealand Atlas of Healthcare Variation was used to establish a regression model to examine dispensing rates by age, gender, district health board (DHB) of domicile and aged residential care usage rates over a 4 year period 2008/09 to 2011/12. RESULTS: On average 24 per 1000 people aged 65+ in New Zealand were dispensed an antipsychotic in any given quarter. Benzodiazepine dispensing rates were even higher, at 109 per 1000 aged 65+. Both rates climbed steeply with age, were higher in females, and had a 1.6 to 1.8 fold variation across DHBs. Rates did not vary significantly with rest home and private hospital residential care usage, but antipsychotic rates appeared related to the use of psychogeriatric and dementia beds. CONCLUSION: Given the evident harms associated with the use of antipsychotic and benzodiazepine medicines in the elderly, and the relatively poor efficacy of antipsychotics in dementia care, prescribing of these medicines should be reassessed. DHBs should examine the causes of the high rates in their area and design interventions to reduce the rates.