Sundseth Anne Cathrine, Gjelstad Svein, Straand Jorund, Rosvold Elin O
a Department of General Practice , Institute of Health and Society, University of Oslo , Oslo , Norway.
b General Practice Research Unit , Institute of Health and Society, University of Oslo , Oslo , Norway.
Scand J Prim Health Care. 2018 Jun;36(2):115-122. doi: 10.1080/02813432.2018.1459164. Epub 2018 Apr 14.
To describe Norwegian general practitioners' (GPs') prescription patterns of benzodiazepines, Z-hypnotics and opioid analgesics (BZO-drugs) to elderly (≥70 years) patients.
DESIGN, SUBJECTS AND SETTING: Cross sectional, observational study. Contact- and prescription data from 148 Norwegian GPs, issued for elderly patients during eight months in 2008. GP-patient contacts were categorized as direct contacts (DC: face-to-face consultations) or indirect contacts (IC: via third party, phone or mail). Explanatory variables were characteristics linked to the GPs, patients, and practices. During analyses, GPs' number of listed patients, share of which for elderly patients, and total number of patient consultations during the period (proxy for practice activity), were categorized in quintiles (Q1-5) by number of GPs.
Number of BZO-drug prescriptions and quantities issued during direct- and indirect GP-patient contacts.
In total, 62% of BZO-prescriptions were issued during ICs. Of all prescriptions, 66% were large quantum packages (50 tablets or more), 62% out of which were prescribed during ICs. During the study period, 50% of the patients received repeat prescriptions. Prescribing during ICs was associated with low over all practice activity (Q1) and many (Q5) older patients on the GP's lists.
GPs' BZO-drug prescribing to elderly occur more frequently during ICs than within DCs, and are more commonly issued as large quantity packages. This indicates that regular- or long-term use among elderly is common, contrasting with previous and current national guidelines, which recommend regular clinical assessments and short time or intermittent use of BZO-drugs. Key Points GPs frequently prescribe benzodiazepines, Z-hypnotics and opioid (BZO) drugs for elderly people. BZO-drugs are frequently issued during indirect GP-patient contacts and in relatively large quantities, indicating regular or long-term use. GPs' BZO-drug prescribing patterns contrast with national guidelines recommending clinical assessment and short time or intermittent use of BZO-drugs.
描述挪威全科医生（GP）给老年（≥70岁）患者开具苯二氮䓬类药物、Z类催眠药和阿片类镇痛药（BZO类药物）的处方模式。
设计、研究对象与研究背景：横断面观察性研究。收集了2008年8个月期间148名挪威全科医生为老年患者开具的联系和处方数据。全科医生与患者的联系分为直接联系（DC：面对面咨询）或间接联系（IC：通过第三方、电话或邮件）。解释变量为与全科医生、患者及诊疗机构相关的特征。在分析过程中，根据全科医生数量将全科医生列出的患者数量、老年患者所占比例以及该期间患者咨询总数（诊疗机构活动的代理指标）分为五分位数（Q1 - 5）。
全科医生与患者直接和间接联系期间开具的BZO类药物处方数量及开具量。
总体而言，62%的BZO类药物处方是在间接联系期间开具的。在所有处方中，66%是大剂量包装（50片或更多），其中62%是在间接联系期间开具的。在研究期间，50%的患者接受了重复处方。间接联系期间的处方开具与总体诊疗活动量低（Q1）以及全科医生名单上老年患者多（Q5）有关。
全科医生给老年患者开具BZO类药物在间接联系期间比直接联系期间更频繁，且更常开具大剂量包装。这表明老年人中常规或长期使用此类药物很常见，这与之前和当前的国家指南相悖，国家指南建议进行定期临床评估以及短期或间歇性使用BZO类药物。要点：全科医生经常为老年人开具苯二氮䓬类药物、Z类催眠药和阿片类（BZO）药物。BZO类药物常在全科医生与患者的间接联系期间开具且数量相对较大，表明存在常规或长期使用情况。全科医生开具BZO类药物的模式与国家指南中建议的临床评估以及短期或间歇性使用BZO类药物相矛盾。
