Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York2New York State Psychiatric Institute, New York.
School of Management, Yale University, New Haven, Connecticut.
JAMA Psychiatry. 2015 Feb;72(2):136-42. doi: 10.1001/jamapsychiatry.2014.1763.
Although concern exists regarding the rate of benzodiazepine use, especially long-term use by older adults, little information is available concerning patterns of benzodiazepine use in the United States.
To describe benzodiazepine prescription patterns in the United States focusing on patient age and duration of use.
DESIGN, SETTING, AND PARTICIPANTS: A retrospective descriptive analysis of benzodiazepine prescriptions was performed with the 2008 LifeLink LRx Longitudinal Prescription database (IMS Health Inc), which includes approximately 60% of all retail pharmacies in the United States. Denominators were adjusted to generalize estimates to the US population.
The percentage of adults filling 1 or more benzodiazepine prescriptions during the study year by sex and age group (18-35 years, 36-50 years, 51-64 years, and 65-80 years) and among individuals receiving benzodiazepines, the corresponding percentages with long-term (≥120 days) benzodiazepine use, prescription of a long-acting benzodiazepine, and benzodiazepine prescriptions from a psychiatrist.
In 2008, approximately 5.2% of US adults aged 18 to 80 years used benzodiazepines. The percentage who used benzodiazepines increased with age from 2.6% (18-35 years) to 5.4% (36-50 years) to 7.4% (51-64 years) to 8.7% (65-80 years). Benzodiazepine use was nearly twice as prevalent in women as men. The proportion of benzodiazepine use that was long term increased with age from 14.7% (18-35 years) to 31.4% (65-80 years), while the proportion that received a benzodiazepine prescription from a psychiatrist decreased with age from 15.0% (18-35 years) to 5.7% (65-80 years). In all age groups, roughly one-quarter of individuals receiving benzodiazepine involved long-acting benzodiazepine use.
Despite cautions concerning risks associated with long-term benzodiazepine use, especially in older patients, long-term benzodiazepine use remains common in this age group. More vigorous clinical interventions supporting judicious benzodiazepine use may be needed to decrease rates of long-term benzodiazepine use in older adults.
尽管人们对苯二氮䓬类药物的使用率，尤其是老年人的长期使用情况存在担忧，但有关美国苯二氮䓬类药物使用模式的信息却很少。
描述美国的苯二氮䓬类药物处方模式，重点关注患者年龄和使用时间。
设计、地点和参与者：对 2008 年 LifeLink LRx 纵向处方数据库（IMS Health Inc）中的苯二氮䓬类药物处方进行了回顾性描述性分析，该数据库包含了美国约 60%的零售药店。对分母进行了调整，以使估计结果能够推广到美国人口。
按性别和年龄组（18-35 岁、36-50 岁、51-64 岁和 65-80 岁），以及在接受苯二氮䓬类药物治疗的患者中，计算出每年有多少成年人填写 1 份或更多苯二氮䓬类药物处方的比例，以及在长期（≥120 天）使用苯二氮䓬类药物、使用长效苯二氮䓬类药物和由精神科医生开具苯二氮䓬类药物处方的患者中，相应的比例。
2008 年，约有 5.2%的 18 至 80 岁的美国成年人使用了苯二氮䓬类药物。使用苯二氮䓬类药物的比例随年龄增长而增加，从 2.6%（18-35 岁）增加到 5.4%（36-50 岁），再增加到 7.4%（51-64 岁），最后增加到 8.7%（65-80 岁）。女性使用苯二氮䓬类药物的比例几乎是男性的两倍。长期使用苯二氮䓬类药物的比例随年龄增长而增加，从 14.7%（18-35 岁）增加到 31.4%（65-80 岁），而由精神科医生开具苯二氮䓬类药物处方的比例则随年龄增长而下降，从 15.0%（18-35 岁）下降到 5.7%（65-80 岁）。在所有年龄组中，大约四分之一接受苯二氮䓬类药物治疗的患者使用了长效苯二氮䓬类药物。
尽管人们对长期使用苯二氮䓬类药物（尤其是老年患者）相关风险提出了警告，但在该年龄组中，长期使用苯二氮䓬类药物仍然很常见。可能需要更积极的临床干预措施，以支持合理使用苯二氮䓬类药物，从而降低老年人长期使用苯二氮䓬类药物的比例。
