Bénard-Laribière Anne, Noize Pernelle, Pambrun Elodie, Bazin Fabienne, Verdoux Hélène, Tournier Marie, Bégaud Bernard, Pariente Antoine
Univ. Bordeaux, U1219, Bordeaux, France.
Inserm U1219, Bordeaux Population Health Research Center, Pharmacoepidemiology research team, Bordeaux, France.
Pharmacoepidemiol Drug Saf. 2017 Feb;26(2):162-169. doi: 10.1002/pds.4123. Epub 2016 Nov 3.
To study trends in incident use of benzodiazepines in France between 2006 and 2012.
A cross-sectional study repeated yearly was conducted using data from the French national healthcare insurance system. New benzodiazepine users were defined as users without any benzodiazepine dispensing in the year prior to the first dispensing of benzodiazepine in each year. Relative changes in incidence of use were calculated with the year 2006 as reference; confidence intervals for changes were estimated using the bootstrap method.
Over the study period, the incident use of benzodiazepines decreased from 6.2% to 5.9%; this corresponded to a 5.1% decrease (95%CI: -6.8% to -4.2%) for 2012 compared to 2006. The decrease mainly concerned hypnotics (-15.5%; -21.2% to -15.3%) and appeared more pronounced in people aged 18-44 years. Incident use of anxiolytics remained stable overall during the period (4.0% of the population). Within anxiolytics, incident use of long half-life benzodiazepines (bromazepam, prazepam) decreased in favor of short half-life benzodiazepines (alprazolam, oxazepam). This change concerned patients aged 65-79 and patients aged 80 years and over. Nevertheless, in 2012, nearly one third of incident users aged 65 years and over started a treatment with a long half-life benzodiazepine, mostly bromazepam.
A limited decrease in incident benzodiazepine use was observed in France between 2006 and 2012 that concerned only hypnotics. Although congruent with recommendations, this improvement appears insufficient with regard to the level of exposure to these drugs in France. New actions especially targeting anxiolytic benzodiazepine use should be undertaken to consolidate these results. Copyright © 2016 John Wiley & Sons, Ltd.
研究2006年至2012年间法国苯二氮䓬类药物的新使用者情况趋势。
利用法国国家医疗保险系统的数据进行每年重复的横断面研究。新的苯二氮䓬类药物使用者定义为在每年首次开具苯二氮䓬类药物处方的前一年未使用过该类药物的使用者。以2006年为参照计算使用发生率的相对变化;使用自助法估计变化的置信区间。
在研究期间,苯二氮䓬类药物的新使用者比例从6.2%降至5.9%;与2006年相比,2012年下降了5.1%(95%置信区间:-6.8%至-4.2%)。下降主要涉及催眠药(-15.5%;-21.2%至-15.3%),且在18至44岁人群中更为明显。在此期间,抗焦虑药的新使用者总体保持稳定(占人口的4.0%)。在抗焦虑药中,长半衰期苯二氮䓬类药物(溴西泮、普拉西泮)的新使用者减少,而短半衰期苯二氮䓬类药物(阿普唑仑、奥沙西泮)的新使用者增加。这种变化涉及65至79岁的患者以及80岁及以上的患者。然而,在2012年,65岁及以上的新使用者中近三分之一开始使用长半衰期苯二氮䓬类药物进行治疗,主要是溴西泮。
2006年至2012年间,法国苯二氮䓬类药物新使用者仅在催眠药方面出现了有限下降。尽管这与建议相符,但就法国这些药物的使用水平而言,这种改善似乎并不充分。应采取特别针对抗焦虑苯二氮䓬类药物使用的新行动,以巩固这些成果。版权所有© 2016约翰威立父子有限公司。