Singh I, Oosthuizen F
Discipline of Pharmaceutical Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
S Afr Med J. 2019 Jan 31;109(2):127-132. doi: 10.7196/SAMJ.2019.v109i2.13347.
Benzodiazepines (BZDs) are highly effective hypnotic and anxiolytic agents and among the most frequently used drugs in the world, but there are significant disadvantages associated with their use. Identifying possible irrational BZD prescribing is important to ensure safe and effective use of these agents. No studies have been conducted in other African countries, and this is the only study in the Western Cape (WC) Province of South Africa (SA), highlighting the paucity of local research.
To identify the most commonly prescribed BZDs at a chronic dispensary unit (CDU) in the WC and describe the indications, co-prescribing patterns and patient factors in different areas of the WC.
A retrospective, quantitative study was carried out using prescription data from a CDU in the Western Cape Department of Health, SA. Data for January 2017 were analysed. Associations between BZD therapeutic indications and co-prescribing patterns were assessed, together with demographic data. Data were coded and descriptive and inferential analysis was done using Stata version 14.
A total of 1 396 prescriptions met the inclusion criteria and were analysed. Overall, clonazepam was the most frequently prescribed BZD (n=691 prescriptions, 49.5%), followed by diazepam (n=298, 21.4%), lorazepam (n=222, 15.9%) and oxazepam (n=185, 13.3%). The most common therapeutic indication for BZDs was epilepsy (n=294, 21.1%), followed by depression (n=166, 11.9%) and depression with concomitant anxiety (n=79, 5.7%). The most common concomitant drug class associated with BZD use was antiepileptics (n=1 581), followed by other BZDs (n=706) and analgesics and antipyretics (n=665). Female patients were more likely than males to be prescribed BZDs (p<0.001), and the mean (standard deviation) age of BZD users was 51.3 (19.5) years.
BZDs were most commonly prescribed to female patients and middle-aged adults. Clonazepam was the most frequently prescribed BZD, indicating a preference for long-acting BZDs. Epilepsy was the most common therapeutic indication and antiepileptics were the most common concomitant drug class prescribed, implying that BZDs have a primary role in the management of epileptic conditions in the public healthcare sector. Future studies should include the private sector, as regulations in the public sector greatly influence the patterns of BZD use.
苯二氮䓬类药物（BZDs）是高效的催眠和抗焦虑药物，也是世界上最常用的药物之一，但使用这些药物存在显著缺点。识别可能不合理的BZD处方对于确保安全有效地使用这些药物很重要。其他非洲国家尚未开展相关研究，这是南非西开普省（WC）唯一的一项研究，凸显了当地研究的匮乏。
确定西开普省一家慢性药房（CDU）最常处方的BZDs，并描述西开普省不同地区的适应证、联合处方模式和患者因素。
采用南非西开普省卫生部一家CDU的处方数据进行回顾性定量研究。分析了2017年1月的数据。评估了BZD治疗适应证与联合处方模式之间的关联以及人口统计学数据。数据进行编码，并使用Stata 14版进行描述性和推断性分析。
共有1396份处方符合纳入标准并进行了分析。总体而言，氯硝西泮是最常处方的BZD（n = 691份处方，49.5%），其次是地西泮（n = 298，21.4%）、劳拉西泮（n = 222，15.9%）和奥沙西泮（n = 185，13.3%）。BZDs最常见的治疗适应证是癫痫（n = 294，21.1%），其次是抑郁症（n = 166，11.9%）和伴有焦虑的抑郁症（n = 79，5.7%）。与BZD使用相关最常见的联合用药类别是抗癫痫药（n = 1581），其次是其他BZDs（n = 706）以及镇痛药和解热药（n = 665）。女性患者比男性患者更有可能被处方BZDs（p < 0.001），BZD使用者的平均（标准差）年龄为51.3（19.
