Department of Clinical Pharmacology, Addictovigilance, University Hospital of Nantes, Nantes, France.
SPHERE U1246 Unit, University of Nantes, University of Tours, INSERM, Nantes, France.
PLoS One. 2020 Feb 19;15(2):e0228495. doi: 10.1371/journal.pone.0228495. eCollection 2020.
Our objective was to quantify the impact on the use of zolpidem of the obligation implemented in France in 2017 to use secure prescription pads to prescribe it. We conducted a cohort study within the French SNDS healthcare database. Patients aged over 18 years of age were considered for inclusion. The number of prevalent users and incident episodes of zolpidem use were compared before the change in law (July 1, 2016 to January 1, 2017) and after (July 1, 2017 to January 1, 2018). A prevalent user was a patient who has been reimbursed for zolpidem at least once. An incident episode of zolpidem use was defined by a first administration of zolpidem without any prior administration within the previous six months. Regarding prevalence of zolpidem users, we observed a decrease from 2.79% (CI95%:2.75-2.83) to 1.48% (1.44-1.51), with a number of patients who stopped taking it after the change in law being approximately 4.3 times higher than the number of patients who started. We observed a negative association between the post-law change period (OR = 0.52 (0.51-0.53)) and the probability of receiving zolpidem, adjusting for sex, aging, low income and chronic disease. We observed a decrease from 183 treatment episodes per 100,000 insured months on average to 79 episodes per 100,000 insured months, with an incidence rate ratio (IRR) equal to 0.43 (0.38-0.49). The use of secure prescription pads seems to have reduced the exposure of the French population to zolpidem.
我们的目的是量化 2017 年法国实施的开具安定类药物需使用安全处方笺这一规定对安定类药物使用的影响。我们在法国 SNDS 医疗保健数据库中进行了一项队列研究。纳入年龄大于 18 岁的患者。在法律变更前（2016 年 7 月 1 日至 2017 年 1 月 1 日）和之后（2017 年 7 月 1 日至 2018 年 1 月 1 日）比较安定类药物的现有使用者数量和新使用者数量。现有使用者是指至少有一次接受过安定类药物报销的患者。新使用者是指在过去 6 个月内未使用过安定类药物而首次使用的患者。关于安定类药物使用者的流行率，我们观察到从 2.79%（95%CI：2.75-2.83）下降到 1.48%（1.44-1.51），法律变更后停止服用安定类药物的患者数量约为开始服用的患者数量的 4.3 倍。在调整了性别、年龄、低收入和慢性病等因素后，我们发现法律变更后的时期与接受安定类药物治疗的可能性之间呈负相关（OR=0.52（0.51-0.53））。我们观察到，平均每 10 万被保险月的治疗次数从 183 次下降到 79 次，发病率比（IRR）等于 0.43（0.38-0.49）。使用安全处方笺似乎减少了法国人群接触安定类药物的机会。
