School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.
Department of General Practice, University College Cork, Cork, Ireland.
Eur J Clin Pharmacol. 2021 Jun;77(6):903-912. doi: 10.1007/s00228-020-03063-z. Epub 2021 Jan 7.
To examine the impact of new controlled drugs legislation introduced in May 2017 on benzodiazepine receptor agonist (BZRA) prescribing in Ireland.
A repeated cross-sectional analysis was conducted using publically available monthly pharmacy claims data from the General Medical Services (GMS) database. The study population comprised all GMS-eligible individuals aged ≥ 16 years from January 2016 to September 2019. Monthly prevalence rates of individuals receiving BZRA prescriptions per 10,000 eligible population were calculated and trends examined over time. Segmented linear regression of prevalence rates was used to examine changes before and after introduction of the legislation stratified by gender and age groups. Regression coefficients (β) and 95% confidence intervals (CIs) for monthly change were calculated.
Pre-legislation (January 2016 to April 2017), there was a significant monthly decline in benzodiazepine prevalence rate (β = - 1.18; 95% CI - 1.84, - 0.51; p < 0.001) but no significant change in Z-drug prescribing. Post-legislation (May 2017 to September 2019), increases in prevalence rates were observed for benzodiazepines (β = 1.04; 95% CI 0.17, 1.92; p = 0.021) and Z-drugs (β = 1.04; 95% CI 0.26, 1.83; p = 0.010). Post-legislation trends showed increases in BZRA prevalence rates among the youngest subgroup (16-44 years), with variable changes in the middle-aged subgroup (45-64 years) and no changes in the oldest subgroup (≥ 65 years).
This study indicates that introduction of new legislation had limited impact on BZRA prescribing on the main public health scheme in Ireland. Interventions targeting specific population subgroups may be required to achieve sustained reductions in prescribing.
研究 2017 年 5 月推出的新管制药物法规对爱尔兰苯二氮䓬受体激动剂（BZRA）处方的影响。
利用通用医疗服务（GMS）数据库中公开的每月药房报销数据，进行了一项重复的横截面分析。研究人群包括 2016 年 1 月至 2019 年 9 月期间，所有符合 GMS 条件的 16 岁以上个体。计算了每月每 10000 名合格人群中接受 BZRA 处方的个体的流行率，并随着时间的推移检查趋势。使用分段线性回归分析流行率，以检查立法前后按性别和年龄组分层的变化。计算了每月变化的回归系数（β）和 95%置信区间（CI）。
在立法之前（2016 年 1 月至 2017 年 4 月），苯二氮䓬的流行率每月呈显著下降趋势（β=-1.18；95%CI-1.84，-0.51；p<0.001），但 Z 药物的处方没有明显变化。在立法之后（2017 年 5 月至 2019 年 9 月），观察到苯二氮䓬（β=1.04；95%CI0.17，1.92；p=0.021）和 Z 药物（β=1.04；95%CI0.26，1.83；p=0.010）的流行率增加。立法后趋势显示，在最年轻的亚组（16-44 岁）中，BZRA 流行率增加，中年亚组（45-64 岁）的变化不同，最年长的亚组（≥65 岁）没有变化。
本研究表明，在爱尔兰主要公共卫生计划中，新法规的引入对 BZRA 处方的影响有限。可能需要针对特定人群亚组的干预措施，以实现持续减少处方。
