Javelot Hervé, Marquis Anne, Antoine-Bernard Emilie, Grandidier Jean, Weiner Luisa, Javelot Thierry, Michel Bruno
Maison Hospitalière de Baccarat, 54120 Baccarat, France.
Service de Pharmacie Clinique, Etablissement Public de Santé Alsace Nord, 67173 Brumath, France.
Pharmacy (Basel). 2018 Apr 6;6(2):30. doi: 10.3390/pharmacy6020030.
Long-term use of benzodiazepines (BZDs) is known to induce tolerance and dependence, and increase the risk of falls-related injuries in older adults. We present a study carried out in a French nursing home that concerns the implementation of a BZD withdrawal program reassessed at one year. BZD deprescription was achieved by gradual cessation of doses. A secondary benefit of this program was assessed by comparing the number of falls among residents before and after withdrawal. The number of falls was recorded over a six-month period prior to the onset of withdrawal (T1) and then over a six-month period after reassessment at one year (T2). At the beginning, 31 (28.7%) of the patients were under BZD. Total deprescription was obtained for 11 patients. The number of falls per patient over the T1 period was not different between the two groups (future non-withdrawn and withdrawn patients in BZD): 2.1 ± 1.3 and 2.3 ± 0.6 falls per resident, respectively. Conversely, the number of falls per patient was significantly decreased in the population completely withdrawn in BZD between the T1 and T2 periods (2.3 ± 0.6 vs. 0.5 ± 0.2 falls, = 0.01). The results show that BZD deprescription, through a gradual reduction of doses, is possible to achieve.
长期使用苯二氮䓬类药物（BZDs）会导致耐受性和依赖性，并增加老年人跌倒相关伤害的风险。我们展示了一项在法国一家养老院进行的研究，该研究涉及一项为期一年重新评估的BZD撤药计划的实施情况。通过逐渐减少剂量实现了BZD的停用。通过比较撤药前后居民跌倒的数量来评估该计划的一个次要益处。在撤药开始前的六个月期间（T1）记录跌倒数量，然后在一年后重新评估后的六个月期间（T2）记录跌倒数量。一开始，31名（28.7%）患者正在使用BZD。11名患者实现了完全停用。两组（未来未停用和已停用BZD的患者）在T1期间每位患者的跌倒数量没有差异：每位居民分别为2.1±1.3次和2.3±0.6次跌倒。相反，在T1和T2期间，完全停用BZD的人群中每位患者的跌倒数量显著减少（2.3±0.6次对0.5±0.2次跌倒，P = 0.01）。结果表明，通过逐渐减少剂量来停用BZD是可以实现的。
