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爱尔兰苯二氮䓬类药物和 Z 类药物的处方情况:2005 年至 2015 年国家处方趋势分析。

Benzodiazepine and Z-drug prescribing in Ireland: analysis of national prescribing trends from 2005 to 2015.

机构信息

School of Pharmacy, Royal College of Surgeons, Ireland, Dublin, Ireland.

School of Pharmacy and Pharmaceutical Sciences, Trinity College, Dublin, Ireland.

出版信息

Br J Clin Pharmacol. 2018 Jun;84(6):1354-1363. doi: 10.1111/bcp.13570. Epub 2018 Apr 16.

Abstract

AIMS

The aim of this study was to examine prescribing trends for benzodiazepines and Z-drugs to General Medical Services (GMS) patients in Ireland.

METHODS

A repeated cross-sectional analysis of the national pharmacy claims database was conducted for GMS patients aged ≥16 years from 2005 to 2015. Prescribing rates per 1000 eligible GMS population were calculated with 95% confidence intervals (CIs). Negative binomial regression was used to determine longitudinal trends and compare prescribing rates across years, gender and age groups. Duration of supply and rates of concomitant benzodiazepine and Z-drug prescribing were determined. Age (16-44, 45-64, ≥65 years) and gender trends were investigated.

RESULTS

Benzodiazepine prescribing rates decreased significantly from 225.92/1000 population (95% CI 224.94-226.89) in 2005 to 166.07/1000 population (95% CI 165.38-166.75) in 2015 (P < 0.0001). Z-drug prescribing rates increased significantly from 95.36/1000 population (95% CI 94.73-96.00) in 2005 to 109.11/1000 population (95% CI 108.56-109.67) in 2015 (P = 0.048). Approximately one-third of individuals dispensed either benzodiazepines or Z-drugs were receiving long-term prescriptions (>90 days). The proportion of those receiving >1 benzodiazepine and/or Z-drug concomitantly increased from 11.9% in 2005 to 15.3% in 2015. Benzodiazepine and Z-drug prescribing rates were highest for older women (≥65 years) throughout the study period.

CONCLUSIONS

Benzodiazepine prescribing to the GMS population in Ireland decreased significantly from 2005 to 2015, and was coupled with significant increases in Z-drug prescribing. The study shows that benzodiazepine and Z-drug prescribing is common in this population, with high proportions of individuals receiving long-term prescriptions. Targeted interventions are needed to reduce potentially inappropriate long-term prescribing and use of these medications in Ireland.

摘要

目的

本研究旨在考察爱尔兰普通医疗服务(GMS)患者开处苯二氮䓬类药物和 Z 类药物的情况。

方法

对 2005 年至 2015 年间年龄≥16 岁的 GMS 患者的国家药房报销数据库进行了重复的横断面分析。计算了每 1000 名符合条件的 GMS 人群中开出的处方率,并计算了 95%置信区间(CI)。使用负二项式回归来确定纵向趋势,并比较各年、性别和年龄组的开方率。还确定了供应持续时间以及同时开具苯二氮䓬类药物和 Z 类药物的处方率。研究了年龄(16-44 岁、45-64 岁、≥65 岁)和性别趋势。

结果

从 2005 年的 225.92/1000 人(95%CI 224.94-226.89)到 2015 年的 166.07/1000 人(95%CI 165.38-166.75),苯二氮䓬类药物的开方率显著下降(P<0.0001)。从 2005 年的 95.36/1000 人(95%CI 94.73-96.00)到 2015 年的 109.11/1000 人(95%CI 108.56-109.67),Z 类药物的开方率显著增加(P=0.048)。大约三分之一开出苯二氮䓬类药物或 Z 类药物的患者正在接受长期处方(>90 天)。同时接受>1 种苯二氮䓬类药物和/或 Z 类药物的患者比例从 2005 年的 11.9%增加到 2015 年的 15.3%。在整个研究期间,年龄较大的女性(≥65 岁)的苯二氮䓬类药物和 Z 类药物的开方率最高。

结论

从 2005 年到 2015 年,爱尔兰 GMS 人群中苯二氮䓬类药物的开方显著减少,同时 Z 类药物的开方显著增加。研究表明,此类人群中苯二氮䓬类药物和 Z 类药物的开方很常见,很大一部分患者接受长期处方。需要采取有针对性的干预措施,以减少爱尔兰此类药物潜在的不合理长期处方和使用。

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