Faculty of Physical Chemistry, University of Belgrade, Belgrade, Serbia.
Psychiatr Danub. 2019 Dec;31(Suppl 5):750-760.
Anxiety disorders are among the most common mental disorders. Benzodiazepines belong to the group of anxiolytic sedatives and the most prescribed drugs in the world. The aim in ours study was to evaluate the differences in the exposure of the population to benzodiazepines (in period from 2014-2018) between Serbia, Slovenia and Croatia, the three countries of the Southwestern Balkans with varying degrees of socioeconomic development.
A academic investigator initiated, pharmacoepidemiological difference-in-difference time series analysis of population exposure to benzodiazepines between the three, geographically close Balkans countries (Slovenia, Serbia, Croatia) with varying degrees of socioeconomic development has been carried out. Study was conducted as academic investigator initiated, in a retrospective manner on monthly basis international data set from January 2014 to December 2018.
At the annual level, during the study period from January 2014 to December 2018, compared to Slovenia, Serbia and Croatia had higher DIDs, from 5 fold (Croatia) to 6 fold (Serbia), for all benzodiazepines in total. By analyzing the differences-in-difference, we have shown that influence of both time (month) and country on DIDs is significant as well as their mutual interaction (the country x month) for all benzodiazepines in total.
Serbia and Croatia must implement explicit measures of reducing benzodiazepine prescription in health primary care based on evidence-based recommendations in the indications where general medicine practitioners/family doctors most commonly prescribe these medicines. Without providing a realistic supplement/alternative to benzodiazepines such as increasing the availability of psychotherapy and improving the structure of psychiatric professionals in healthcare settings, implicit measures are not recommended for reducing prescription, implementing accountability measures for prolonged prescription of benzodiazepines, and in particular for "masked" somatic diseases. All this comes to the fore by raising economic development and socioeconomic stability.
焦虑障碍是最常见的精神障碍之一。苯二氮䓬类药物属于抗焦虑镇静剂，是世界上使用最广泛的药物之一。我们的研究目的是评估 2014 年至 2018 年间，社会经济发展程度不同的三个西南巴尔干国家（塞尔维亚、斯洛文尼亚和克罗地亚）的人群对苯二氮䓬类药物的暴露差异。
本研究采用学术研究者发起的、基于人口的、药物流行病学差异-差异时间序列分析方法，对三个地理位置相近、社会经济发展程度不同的巴尔干国家（斯洛文尼亚、塞尔维亚、克罗地亚）的人群使用苯二氮䓬类药物的情况进行了分析。本研究为回顾性研究，以学术研究者发起的方式，每月对 2014 年 1 月至 2018 年 12 月的国际数据进行分析。
在研究期间（2014 年 1 月至 2018 年 12 月），与斯洛文尼亚相比，塞尔维亚和克罗地亚的年度 DID 值更高，所有苯二氮䓬类药物的 DID 值均从 5 倍（克罗地亚）到 6 倍（塞尔维亚）不等。通过分析差异差异，我们表明时间（月份）和国家对 DID 的影响以及它们之间的相互作用（国家 x 月份）都是显著的，这适用于所有苯二氮䓬类药物。
塞尔维亚和克罗地亚必须根据一般医学从业者/家庭医生最常开这些药物的适应症，实施基于循证建议的减少苯二氮䓬类药物处方的明确措施。在没有为减少处方提供现实的补充/替代方案的情况下，如增加心理治疗的可及性和改善精神卫生保健机构中的精神科专业人员结构，不建议采取隐性措施来减少处方，实施对延长苯二氮䓬类药物处方的问责措施，特别是对“伪装”躯体疾病的处方。所有这些都通过提高经济发展和社会经济稳定而凸显出来。
