Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Carlton, Australia.
Division of Dentistry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.
Am J Prev Med. 2021 Jul;61(1):73-79. doi: 10.1016/j.amepre.2021.01.025. Epub 2021 Mar 26.
Benzodiazepines contribute to substance use disorder and are often part of polydrug abuse, most frequently with opioids. Although dental opioid prescribing differs significantly between countries, little is known about the patterns of dental benzodiazepine prescribing. The aim of this study is to compare dental prescribing of benzodiazepines among the U.S., England, and Australia in 2013-2018.
Population-level data were accessed from national data sets for each country for dental benzodiazepine prescriptions. Outcome measures of dental benzodiazepine prescribing included: (1) prescribing rates by population for each year and (2) the quantity and relative proportion of benzodiazepines by type for each country. The analysis was conducted in 2020.
Between 2013 and 2018, U.S. dentists prescribed 23 times more than English dentists and 7 times more than Australian dentists by population. During the study period, the rate of dental benzodiazepine prescribing decreased in England and the U.S. but increased in Australia. Despite these trends, U.S. dental prescribing rates remained 28 times more than English dentists and 6 times more than Australian dentists in 2018 (U.S., 3.10 prescriptions/1,000 population; England, 0.11 prescriptions/1,000 population; Australia, 0.50 prescriptions/1,000 population). U.S. dentists prescribed a wider variety of benzodiazepines than English and Australian dentists. Diazepam was most commonly prescribed in all countries. In the U.S., triazolam, lorazepam, and alprazolam were next most commonly prescribed. Temazepam was next most frequent in England and Australia.
Significant variation in benzodiazepine prescribing rates and types were seen among the countries. To improve patient safety, further investigation into the appropriate use and choices of benzodiazepines in dentistry is needed.
苯二氮䓬类药物会导致物质使用障碍，并且通常是多种药物滥用的一部分，最常见的是与阿片类药物一起滥用。尽管各国之间的牙科阿片类药物处方有很大差异，但对于牙科苯二氮䓬类药物处方模式知之甚少。本研究旨在比较 2013-2018 年美国、英国和澳大利亚的牙科苯二氮䓬类药物处方情况。
从每个国家的国家数据库中获取了人口水平数据，以获取牙科苯二氮䓬类药物处方。牙科苯二氮䓬类药物处方的主要结果指标包括：（1）每年按人口计算的处方率；（2）每种药物的类型和相对比例。该分析于 2020 年进行。
在 2013 年至 2018 年间，美国牙医的处方量是英国牙医的 23 倍，是澳大利亚牙医的 7 倍。在研究期间，英国和美国的牙科苯二氮䓬类药物处方率下降，但澳大利亚的处方率上升。尽管存在这些趋势，但 2018 年美国牙医的处方率仍分别是英国牙医的 28 倍和澳大利亚牙医的 6 倍（美国，3.10 张/1000 人；英国，0.11 张/1000 人；澳大利亚，0.50 张/1000 人）。与英国和澳大利亚牙医相比，美国牙医开的苯二氮䓬类药物种类更多。所有国家最常开的药物都是地西泮。在美国，三唑仑、劳拉西泮和阿普唑仑是接下来最常开的药物。在英国和澳大利亚，替马西泮是最常开的药物。
在这些国家之间，苯二氮䓬类药物的处方率和类型存在显著差异。为了提高患者安全性，需要进一步调查牙科中苯二氮䓬类药物的合理使用和选择。
