Oster G, Russell M W, Huse D M, Adams S F, Imbimbo J
Policy Analysis, Inc., Brookline, MA 02146.
J Clin Psychiatry. 1987 Dec;48 Suppl:17-21.
Benzodiazepine tranquilizers have been found to cause psychomotor and cognitive impairment, and there is evidence of an increased rate of automobile accidents among users of these drugs. To determine whether benzodiazepine users are more likely than nonusers to experience accidental injury requiring medical attention, we examined health-care utilization among 7,271 such users and an age- and sex-matched sample of 65,439 nonusers, all of whom were enrolled in an "HMO-like" health insurance plan. Benzodiazepine users and nonusers were identified through a review of 4 months' prescription drug claims. Six months' health-care claims for each user and nonuser subsequent to the first observed claim for a benzodiazepine or nonbenzodiazepine agent, respectively, were compiled. Claims related to accidents were identified on the basis of physician-recorded diagnoses. Our results indicate that benzodiazepine users were significantly (p less than .01) more likely than nonusers to experience (1) at least one accident-related episode of care; (2) a greater number of accident-related hospital admissions; and (3) a greater number of accident-related inpatient days. Accident-related utilization was also significantly higher when users had recently filled a prescription for a benzodiazepine agent. Benzodiazepine users, however, also utilized significantly more non-accident-related health-care services than nonusers. The nature of the association between benzodiazepine use and a higher accident-related utilization is thus unclear. A pretest-posttest study is now being undertaken to ascertain the significance of these findings.
已发现苯二氮䓬类镇静剂会导致精神运动和认知功能损害,且有证据表明这些药物使用者发生汽车事故的几率增加。为了确定苯二氮䓬类药物使用者比非使用者更有可能经历需要医疗护理的意外伤害,我们调查了7271名此类使用者以及65439名年龄和性别匹配的非使用者的医疗保健利用情况,所有这些人都参加了类似健康维护组织(HMO)的医疗保险计划。通过审查4个月的处方药报销记录来识别苯二氮䓬类药物使用者和非使用者。分别收集了每位使用者和非使用者在首次观察到使用苯二氮䓬类药物或非苯二氮䓬类药物后的6个月医疗保健报销记录。根据医生记录的诊断来识别与事故相关的报销记录。我们的结果表明,苯二氮䓬类药物使用者比非使用者更有可能显著(p<0.01)经历以下情况:(1)至少一次与事故相关的护理事件;(2)更多与事故相关的住院治疗;以及(3)更多与事故相关的住院天数。当使用者最近开具了苯二氮䓬类药物的处方时,与事故相关的医疗保健利用也显著更高。然而,苯二氮䓬类药物使用者使用的非事故相关医疗保健服务也比非使用者显著更多。因此,苯二氮䓬类药物使用与更高的事故相关医疗保健利用之间关联的性质尚不清楚。目前正在进行一项前后测研究,以确定这些发现的意义。