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老年人中苯二氮䓬类药物使用增加:班布伊项目

Increased use of benzodiazepines among older adults: Bambuí Project.

作者信息

Oliveira Aline Luiza Marcondes Lopes, Nascimento Mariana Martins Gonzaga do, Castro-Costa Érico, Firmo Josélia Oliveira Araújo, Lima-Costa Maria Fernanda, Loyola Filho Antônio Ignácio de

机构信息

Programa de Pós-Graduação em Saúde Coletiva, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, MG, Brazil.

Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

出版信息

Rev Bras Epidemiol. 2020;23:e200029. doi: 10.1590/1980-549720200029. Epub 2020 May 11.

Abstract

BACKGROUND

Benzodiazepines are the most widely used psychoactive drugs, despite the risks associated with their prolonged use, especially among older adults.

OBJECTIVE

To investigate the use of benzodiazepines among community-dwelling people aged ≥ 75 years.

METHODS

The study was conducted among members of the baseline (in 1997) and survivors (in 2012) of the Bambuí Project cohort. The prevalence of benzodiazepine use was estimated separately for each year, and the comparison between them was performed using the Poisson regression model with robust variance.

RESULTS

The prevalence of benzodiazepine use was higher in 2012 (33.9%) compared to 1997 (24.9%). After multiple adjustments, the difference in prevalence did not remain significant in study population (PR = 1.25; 95%CI 0.99 - 1.60), unlike that observed in the female stratum (PR = 1.38; 95%CI 1.04 - 1.84). Clonazepam was the strongest-growing drug between the two years (PR = 4.94; 95%CI 2.54 - 9.62).

CONCLUSION

This study showed an important increase in benzodiazepine use in an older adult population. These results are concerning as these drugs are contraindicated for use in older adults, mainly if used chronically, and are available in the national list of essential medicines. Health professionals should be aware of the risks involved in its use regarding this population.

摘要

背景

苯二氮䓬类药物是使用最广泛的精神活性药物,尽管长期使用存在风险,尤其是在老年人中。

目的

调查年龄≥75岁的社区居民中苯二氮䓬类药物的使用情况。

方法

该研究在班布伊项目队列的基线成员(1997年)和幸存者(2012年)中进行。分别估计每年苯二氮䓬类药物的使用患病率,并使用具有稳健方差的泊松回归模型对两者进行比较。

结果

2012年苯二氮䓬类药物的使用患病率(33.9%)高于1997年(24.9%)。经过多次调整后,研究人群中患病率的差异不再显著(PR = 1.25;95%CI 0.99 - 1.60),这与女性亚组中观察到的情况不同(PR = 1.38;95%CI 1.04 - 1.84)。氯硝西泮是这两年间增长最强劲的药物(PR = 4.94;95%CI 2.54 - 9.62)。

结论

本研究表明老年人群中苯二氮䓬类药物的使用有显著增加。这些结果令人担忧,因为这些药物禁止在老年人中使用,尤其是长期使用,并且在国家基本药物清单中也有。卫生专业人员应意识到在该人群中使用此类药物的风险。

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